Document Detail

Unexplained prelabor uterine rupture in a term primigravida.
MedLine Citation:
PMID:  17018479     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Uterine rupture is a catastrophic obstetric complication. The main risk factor is a scarred uterus, usually secondary to a previous cesarean delivery. Uterine rupture in a primigravid woman is a very rare event. CASE: A 33-year-old primigravida presented at term with severe abdominal pain, signs of hemodynamic instability, and fetal bradycardia. She was not in labor, and the fetal heart tones disappeared before a cesarean could be performed. After a failed attempt at induction, exploratory laparotomy was performed for worsening maternal hemodynamic status. A complete rupture of the posterior uterine wall was found with a well-grown fetus free in the abdominal cavity. The uterus was repaired in two layers, and the patient did well postoperatively. CONCLUSION: We report the rare occurrence of a spontaneous uterine rupture in a nonlaboring primigravid with no known risk factors. The differential diagnosis of this presentation includes concealed placental abruption, subhepatic hematoma with or without liver rupture, splenic rupture, rupture of the broad ligament, and rupture of a uterine vein. Although uterine rupture occurs more commonly in the multiparous population, it cannot be assumed that the primigravid uterus is immune to rupture.
Colin A Walsh; Ray J O'Sullivan; Michael E Foley
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  108     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-10-04     Completed Date:  2006-10-24     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  725-7     Citation Subset:  AIM; IM    
National Maternity Hospital, Dublin, Ireland.
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MeSH Terms
Abdominal Pain
Blood Transfusion
Fetal Death
Fetal Diseases
Heart Rate, Fetal
Uterine Rupture / diagnosis*,  surgery
Comment In:
Obstet Gynecol. 2007 Feb;109(2 Pt 1):455   [PMID:  17267858 ]

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