2023
Conservative management of complete fetal expulsion into the abdominal cavity after silent uterine rupture - case report
HRUBAN, Lukáš, Anna JOUZOVÁ, Petr JANKŮ, Vít WEINBERGER, Dagmar SEIDLOVÁ et. al.Základní údaje
Originální název
Conservative management of complete fetal expulsion into the abdominal cavity after silent uterine rupture - case report
Autoři
HRUBAN, Lukáš (203 Česká republika, domácí), Anna JOUZOVÁ (203 Česká republika, garant, domácí), Petr JANKŮ (203 Česká republika, domácí), Vít WEINBERGER (203 Česká republika, domácí), Dagmar SEIDLOVÁ (203 Česká republika, domácí), Tomáš JUREN (203 Česká republika, domácí), Jan ŠENKYŘÍK (203 Česká republika, domácí), Jana KADLECOVÁ (203 Česká republika, domácí), Jitka HAUSNEROVÁ (203 Česká republika, domácí) a Eva JANDÁKOVÁ (203 Česká republika, domácí)
Vydání
BMC Pregnancy and Childbirth, London, BMC, 2023, 1471-2393
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30214 Obstetrics and gynaecology
Stát vydavatele
Velká Británie a Severní Irsko
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 3.100 v roce 2022
Kód RIV
RIV/00216224:14110/23:00131857
Organizační jednotka
Lékařská fakulta
UT WoS
001024972800001
Klíčová slova anglicky
Silent uterine rupture; Abdominal pregnancy; Fetal expulsion; Uterine scar
Změněno: 15. 3. 2024 10:21, Mgr. Tereza Miškechová
Anotace
V originále
Background Clinically silent uterine rupture with complete fetal expulsion into the abdominal cavity is an extremely rare complication. Diagnosis can be difficult and the risk to the mother and fetus is high. Conservative management has been described only in a few cases of partial expulsion of the fetus so far. Case presentation We present a case of 43-year-old tercigravida with a history of previous laparotomic myomectomy and subsequent cesarean section. The subsequent pregnancy was complicated by uterine wall loosening and rupture at the site of the previous uterine scar after myomectomy and complete fetal expulsion into the abdominal cavity. The diagnosis was made at 24 + 6 weeks of gestation. Considering the absence of clinical symptomatology and the good condition of the fetus, a conservative approach was chosen with intensive monitoring of the maternal and fetal conditions. The pregnancy ended by elective cesarean section and hysterectomy at 28 + 0 weeks of gestation. The postpartum course was uneventful and the newborn was discharged to home care 63 days after delivery. Conclusions Fetal expulsion into the abdominal cavity after silent uterine rupture of the scarred uterus may be accompanied by minimal symptomatology making early diagnosis difficult. This rare complication must be considered in the differential diagnosis in women after major uterine surgery. In selected cases and under conditions of intensive maternal and fetal monitoring, conservative management may be chosen to reduce the risks associated with prematurity.