Uterine Anomaly. Esra Nur Tola* Unscarred uterine rupture (UUR) is a rare event that usually occurs in late pregnancy or during labour. Fit For Free, Utrecht (stad) (Utrecht). likes. Fitnesscentrum in Utrecht. Fitness al vanaf €11,99 per maand!. ‘I с) Planet explicatîo nominis, quam Simonis дине, vpcem СОШ— poñlam effe „ пуп; aes et “С! draw f. fer/Jans, utiLa uur’ ‘гати ferpcns amc-ns d’ictus Пс. \_ 4.

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Spontaneous uterine rupture is a life-threatening obstetrical emergency carrying a high risk for uut mother and the fetus.

Spontaneous uterine rupture in early pregnancy is very rare complication and it occurs usually in scarred uterus. Uterine anomalies are one of the reasons for spontaneous unscarred uterine rupture in early pregnancy.

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Obstetricians must consider this diagnosis when a pregnant patient presented with acute abdomen in early pregnancy. We present a case of spontaneous uterine rupture at 12 weeks of gestation in year-old multigravida who had uterine anomaly presenting as an acute abdomen. Our preoperative diagnosis was ectopic pregnancy. Emergency laparotomy confirmed a spontaneous uterine rupture. Uterine anomaly is a risk factor for spontaneous uterine rupture in the early pregnancy.

Clinical signs of uterine rupture in early pregnancy are nonspecific and must be distinguished from acute abdominal emergencies. Rupture of a pregnant uterus is one of the life-threatening complications associated with obstetric practice [ 1 ].

There are several risk factors associated with uterine rupture URbut the most common is a previous Cesarean section. Unscarred uterine rupture UUR is a rare event that usually dsra in late pregnancy or during labour. Risk factors for UUR include high parity, placental abnormalities, and uterine anomaly. UUR during pregnancy, especially before the end of the second trimester, occurs relatively rarely and is associated with high mortality and morbidity for both the fetus and mother.

We here report a case of a spontaneous unscarred uterine rupture SUUR in early pregnancy, in a woman with a bicornuate uterus. A year-old woman was admitted to our department with 3-month amenorrhea and sudden, severe, uir abdominal pain and vaginal bleeding of 2-hour duration. Her first pregnancy resulted in abortus at 8 gestational weeks, but no surgical procedure was performed.

The abdomen was tender. Ultrasound examination revealed a week consistent, fetal heartbeat negative pregnancy in the left tuboovarian area and free fluid in the Douglas pouch. Due to unstable vital signs, two units of screened blood were cross-matched, and the patient was rushed to the operating room. Laparotomy revealed haemoperitoneum of 1 liter.

In the abdomen, a week pregnancy consistent fetus was found. The products of conception were removed, and uterine repair was performed with a size of 1 vicryl suture.

The patient’s postoperative recovery was uneventful and she was discharged on her third postoperative day. The patient was counselled on the need to be delivered by elective Cesarean section in subsequent pregnancies. UUR is a rare, life-threatening complication during pregnancy, with an incidence rate of 1: UR is usually observed in association with uterine scarring either in late pregnancy or during labour [ 4 ].

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First and early second trimester UURs are very rare, and there are only a few cases in literature describing first and early second trimester UURs [ 4 — 7 ]. In our case, UUR occurred in the twelfth week of pregnancy. Other risk factors for UUR include abnormal placentation, uterine anomalies, obstetric manoeuvres, malpresentations, excessive uterine expressions, curettage, injudicious use of oxytocin, uterine diverticula [ 8 ], and chronic corticosteroid use [ 3 ], whereas some cases have no obvious cause [ 9 ].

In our case, uterine anomaly may be implicated in the UR, because the patient had a bicornuate uurr, and there were no edra obvious risk factors. Singh and Jain and Kahyaoglu hur al. A few cases of UUR in the early trimester with no previous risk factors [ 57 ] and as a result of placenta percreta, have been reported [ 1112 ersa.

Clinical signs of UR in early pregnancy are nonspecific and must be distinguished from acute abdominal emergencies.

Abdominal pain, vaginal bleeding, and vomiting are classic findings. Differential diagnoses are bleeding corpus luteum, heterotropic or ectopic pregnancy, and molar pregnancy with secondary invasion [ 4 ]. The most relevant differential diagnosis is ectopic pregnancy [ 6 ].

Sometimes ultrasound has limited value and urgent surgery is necessary to prevent catastrophic sequelae. An emergency laparoscopy or laparotomy is needed for uu correct diagnosis and to enable the necessary treatment to take place. Early correct diagnosis and uhr management are necessary to decrease the high maternal and fetal mortality and morbidity rates associated with UR.

In our case, our initial diagnosis was ectopic pregnancy, and we performed emergency laparotomy after judging that laparoscopic instrumentation was deficient and esfa of the unstable vital signs of the patient. UUR usually occurs in the lower segment the weakest part of uterus [ 13 ]. If the rupture part is the fundus, as in our case, the diagnosis is often delayed because the haemorrhage is not revealed immediately, as blood collects in the intraperitoneal space [ 13 ]. Early surgical intervention is usually the key to successful treatment of UR.

Treatment will primarily depend on the extent of the lesion, the parity, age and condition of the patient, and expertise of the surgeon. For this reason the patient must be counselled on the need to undergo a Cesarean section in all future pregnancies.

In our case we performed uterine suture without tubal ligation because our patient had no previous children. In conclusion, UUR in early pregnancy is a rare and potentially catastrophic event. Uterine anomalies are one of the reasons of UUR. The current case highlights uterine anomaly as a risk factor for spontaneous UR in the first trimester of pregnancy. Clinical signs of UR in early pregnancy are nonspecific and must be distinguished from other acute abdominal emergencies.

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The author declares that there is no conflict of interests regarding the publication of this paper. National Center for Biotechnology InformationU. Case Rep Obstet Gynecol. Published online Jan Author information Article notes Copyright and License information Disclaimer. Received Oct 3; Accepted Nov This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

This article has been cited by other articles in PMC. Abstract Spontaneous uterine rupture is a life-threatening obstetrical emergency carrying a high risk for the mother and the fetus.

Introduction Rupture of a pregnant uterus is one of the life-threatening complications associated with obstetric practice [ 1 ]. Case Report A year-old woman was admitted to our department with 3-month amenorrhea and sudden, severe, generalized abdominal pain and vaginal bleeding of 2-hour duration.

Open in a separate window. Fundal uterine rupture in the left part of the bicornuate uterus.

Discussion UUR is a rare, life-threatening complication during pregnancy, with an incidence rate of 1: Conclusion In conclusion, UUR in early pregnancy is a rare and potentially catastrophic event. Unscarred uterine rupture SUUR: Spontaneous unscarred uterine rupture UR: Conflict of Interests The author declares that there is no conflict of interests regarding the publication of this paper.

Spontaneous uterine rupture of an unscarred uterus before labour. Case Reports in Obstetrics and Gynecology. American Journal of Obstetrics and Gynecology. Rupture of the pregnant uterus: Obstetrical and Gynecological Survey.

Spontaneous uterine rupture during the 1st trimester: Journal of Obstetrics and Gynaecology. Spontaneous uterine rupture in the first trimester of pregnancy. Singh A, Jain S.

First Trimester Spontaneous Uterine Rupture in a Young Woman with Uterine Anomaly

Spontaneous rupture of unscarred uterus in early pregnancy—a rare entity. Acta Obstetricia et Gynecologica Scandinavica. Spontaneous uterine rupture and hemoperitoneum in the first trimester.

American Journal of Perinatology. Spontaneous rupture of unscarred uterus eara 27 weeks of gestation. Archives of Gynecology and Obstetrics. Rupture of the uterus in a primigravida: Nigerian Journal of Clinical Practice. Morken NH, Henriksen H. Plasenta percreata—two cases and review of the literature. Placenta percreta with spontaneous rupture of an yur uterus in the second trimester. The spontaneous prelabour rupture of an unscarred uterus at 34 weeks of pregnancy.

Journal of Clinical and Diagnostic Research. Uterine rupture of the unscarred uterus. Support Center Support Center. Please review our privacy policy.