Document Detail

Large uterine defect found at cesarean section. A case report.
MedLine Citation:
PMID:  12611099     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Uncomplicated uterine perforation has been considered a benign event. Since the advent of operative hysteroscopy, there have been several reports of uterine rupture during pregnancy in patients who have undergone that procedure when complicated by known or unsuspected uterine perforation. Large fundal defects without rupture have also been reported. CASE: A 23-year-old, white woman was admitted for labor induction at 42 weeks' gestation. After an unsuccessful attempt at labor induction, a cesarean section (C/S) was performed. At that time a large (5-cm) fundal defect was noted. A thorough history suggested that the defect was probably the result of unsuspected perforation of the uterus during dilatation and currettage for a late first-trimester fetal death. A follow-up hysterosalpingogram was done and consultation obtained regarding future management. A course of expectant management with C/S prior to the onset of labor was advised. Three years later, after an uncomplicated pregnancy, a repeat C/S was done at 38 weeks' gestation. CONCLUSION: Patients with a history of operative hysteroscopy or difficult curettage may have sustained known or unsuspected perforations of the uterus with subsequent scarring or defect, placing them at some risk of uterine rupture during pregnancy. Patients should be counseled regarding these risks, and assessment by hysterography might be helpful.
William C Reed
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  48     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-03-03     Completed Date:  2003-05-15     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  60-2     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Enloe Medical Center, Chico, California, USA.
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MeSH Terms
Cesarean Section*
Fetal Macrosomia / ultrasonography*
Follow-Up Studies
Labor Onset
Labor, Induced
Obstetric Labor Complications / diagnosis,  surgery*
Pregnancy Trimester, Third
Risk Assessment
Ultrasonography, Prenatal
Uterine Perforation / prevention & control*
Uterus / abnormalities*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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