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Silent rupture of uterus at 32-week gestation – a case report
  1. LC Meehan,
  2. M Fitzsimmons,
  3. JC Dornan
  1. Royal Jubilee Maternity Hospital, Belfast, UK

Abstract

A 31 year old para 0+1 had a right salpingo-ophorectomy in 2004 for an ovarian cyst. The remaining tubal stump was removed in October 2008 following an ectopic pregnancy. She was pregnant within 3 months.

At 32+3 weeks gestation she presented with non specific lower abdominal pain and was admitted and treated as a urinary tract infection and discharged home day 3.

Severe abdominal pain ensued at 34+1 weeks gestation. Abruption was suspected. A detailed scan showed an extra-uterine fluid filled area in the right hypochondrium. A subsequent scan confirmed a retroplacental clot measuring 8 cm. As she had stabilised she was observed with close monitoring. At 34+6 weeks the pain had not completely abated, a further fetal assessment revealed severe oligohydramnios.

At emergency caesarean section there was a 10 cm uterine rupture at the right cornua. The area was ragged but avascular and was sutured in three layers. A live male infant was delivered weighing 2.5 g.

A literature review reveals one similar case where cornual rupture occurred at 14 weeks gestation post salpingectomy but there is no case in the literature where the baby survived.1

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