J 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.

Basic information

Original name

Conservative management of complete fetal expulsion into the abdominal cavity after silent uterine rupture - case report

Authors

HRUBAN, Lukáš (203 Czech Republic, belonging to the institution), Anna JOUZOVÁ (203 Czech Republic, guarantor, belonging to the institution), Petr JANKŮ (203 Czech Republic, belonging to the institution), Vít WEINBERGER (203 Czech Republic, belonging to the institution), Dagmar SEIDLOVÁ (203 Czech Republic, belonging to the institution), Tomáš JUREN (203 Czech Republic, belonging to the institution), Jan ŠENKYŘÍK (203 Czech Republic, belonging to the institution), Jana KADLECOVÁ (203 Czech Republic, belonging to the institution), Jitka HAUSNEROVÁ (203 Czech Republic, belonging to the institution) and Eva JANDÁKOVÁ (203 Czech Republic, belonging to the institution)

Edition

BMC Pregnancy and Childbirth, London, BMC, 2023, 1471-2393

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30214 Obstetrics and gynaecology

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 3.100 in 2022

RIV identification code

RIV/00216224:14110/23:00131857

Organization unit

Faculty of Medicine

DOI

UT WoS

001024972800001

Keywords in English

Silent uterine rupture; Abdominal pregnancy; Fetal expulsion; Uterine scar

Tags

Změněno: 15/3/2024 10:21, Mgr. Tereza Miškechová

Abstract

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.