Case Report
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A Case of Spontaneous Uterine Fundus Rupture in Term Pregnancy: As A Risk Factor of Septum Resection Operation

Year 2024, , 105 - 109, 26.09.2024
https://doi.org/10.46969/EZH.1520857

Abstract

Uterine septum is the most common Mullerian anomaly. Hysteroscopic surgeries offer increased fertility rates caused by Mullerian anomalies. Uterine rupture after hysteroscopic septum resection is a rare complication with a reported incidence of approximately 1-2,7%. Uterine rupture in pregnancy is a life-threatening complication. The primary risk factors for uterine rupture after a previous cesarean birth are previous uterine rupture. Also hysteroscopic surgeries such as septum resection are known risk factors for uterine rupture in pregnancy following the operation. In this report, a patient with a history of hysteroscopic septum resection due to uterine septum presented to our hospital at 37 weeks of gestation due to spontaneous premature rupture of membranes. After the procedure, the patient, who had her first pregnancy, but she had a history of previous cesarean section, was taken to emergency cesarean section. On observation, uterine rupture at the fundus level, which can be considered as a late complication of septum resection, was detected. In this case, we aimed to emphasize uterine rupture, which is an important complication that may occur in pregnancies after a history of septum resection. In rarely, uterine rupture may occur in pregnancies after hysteroscopic resection of the uterine septum. But there is no consensus on the management of pregnancies after hysteroscopic operations. Until more reliable methods are available, patients should be informed about the possible symptoms of uterine rupture and the physician should be aware of fetal and maternal well-being.

References

  • Raga F, Bauset C, Remohi J, Bonilla-Musoles F, Simón C, Pellicer A. Reproductive impact of congenital Müllerian anomalies. Hum Reprod. 1997;12(10):2277-81. https://doi.org/10.1093/humrep/12.10.2277
  • Heinonen PK, Saarikoski S, Pystynen P. Reproductive performance of women with uterine anomalies. An evaluation of 182 cases. Acta Obstet Gynecol Scand. 1982;61(2):157-62. https://doi.org/10.3109/00016348209156548
  • Cooper JM, Brady RM. Late complications of operative hysteroscopy. Obstet Gynecol Clin North Am. 2000;27(2):367-74. https://doi.org/10.1016/s0889-8545(00)80027-3
  • Landon MB, Lynch CD. Optimal timing and mode of delivery after cesarean with previous classical incision or myomectomy: a review of the data. Semin Perinatol. 2011;35(5):257-61. https://doi.org/10.1053/j.semperi.2011.05.008
  • Rossi AC, Prefumo F. Pregnancy outcomes of induced labor in women with previous cesarean section: a systematic review and meta-analysis. Arch Gynecol Obstet. 2015;291(2):273-80. https://doi.org/10.1007/s00404-014-3444-9
  • Roberge S, Chaillet N, Boutin A, et al. Single- versus double-layer closure of the hysterotomy incision during cesarean delivery and risk of uterine rupture. Int J Gynaecol Obstet. 2011;115(1):5-10. https://doi.org/10.1016/j.ijgo.2011.04.013
  • National Institutes of Health Consensus Development conference statement: vaginal birth after cesarean: new insights March 8-10, 2010. Obstet Gynecol. 2010;115(6):1279-95. https://doi.org/10.1097/aog.0b013e3181e459e5
  • Wen SW, Huang L, Liston R, et al. Severe maternal morbidity in Canada, 1991-2001. CMAJ. 2005;173(7):759-64. https://doi.org/10.1503/cmaj.045156
  • Jansa V, Laganà AS, Ferrari F, et al. Uterine rupture in pregnancy after hysteroscopic septum resection: a 20-year retrospective analysis. Minim Invasive Ther Allied Technol. 2022;31(3):448-55. https://doi.org/10.1080/13645706.2020.1837884

Term Gebelikte Spontan Uterus Fundus Rüptürü Olgusu: Bir Risk Faktörü Olarak Septum Rezeksiyonu Operasyonu

Year 2024, , 105 - 109, 26.09.2024
https://doi.org/10.46969/EZH.1520857

Abstract

Uterin septum en sık görülen Müllerian anomalidir. Histeroskopik ameliyatlar Müllerian anomalilerin neden olduğu fertilite oranlarında artış sağlar. Histeroskopik septum rezeksiyonu sonrası uterus rüptürü nadir görülen bir komplikasyondur ve insidansı yaklaşık %1-2,7 olarak bildirilmiştir. Gebelikte uterus rüptürü hayatı tehdit eden bir komplikasyondur. Geçirilmiş sezaryen doğum sonrası uterus rüptürü için primer risk faktörü ise geçirilmiş uterin rüptürdür. Ayrıca septum rezeksiyonu gibi histeroskopik cerrahiler de operasyon sonrası gebelikte uterus rüptürü için bilinen risk faktörleridir. Bu olgu raporunda, uterin septum nedeniyle histeroskopik septum rezeksiyonu öyküsü olan bir hasta 37. gebelik haftasında spontan erken membran rüptürü nedeniyle hastanemize başvurdu. İşlem sonrası ilk gebeliği olan ancak daha önce sezaryen öyküsü bulunan hasta acil sezaryene alındı. Gözlemde septum rezeksiyonunun geç bir komplikasyonu olarak değerlendirilebilecek fundus seviyesinde uterus rüptürü tespit edildi. Bu olguda, septum rezeksiyonu öyküsü olan gebeliklerde ortaya çıkabilecek önemli bir komplikasyon olan uterus rüptürünü vurgulamayı amaçladık. Uterin septumun histeroskopik rezeksiyonu sonrası gebeliklerde uterin rüptür nadir de olsa görülebilir. Ancak histeroskopik operasyonlardan sonra gebeliklerin yönetimi konusunda bir fikir birliği yoktur. Daha güvenilir yöntemler bulunana kadar, hastalar uterus rüptürünün olası semptomları hakkında bilgilendirilmelidir ve uzman fetal ve maternal iyilik halini gözeterek karar vermelidir.

Ethical Statement

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Supporting Institution

Yazarlar araştırma için finansal bir destek almadıklarını beyan etmiştir.

References

  • Raga F, Bauset C, Remohi J, Bonilla-Musoles F, Simón C, Pellicer A. Reproductive impact of congenital Müllerian anomalies. Hum Reprod. 1997;12(10):2277-81. https://doi.org/10.1093/humrep/12.10.2277
  • Heinonen PK, Saarikoski S, Pystynen P. Reproductive performance of women with uterine anomalies. An evaluation of 182 cases. Acta Obstet Gynecol Scand. 1982;61(2):157-62. https://doi.org/10.3109/00016348209156548
  • Cooper JM, Brady RM. Late complications of operative hysteroscopy. Obstet Gynecol Clin North Am. 2000;27(2):367-74. https://doi.org/10.1016/s0889-8545(00)80027-3
  • Landon MB, Lynch CD. Optimal timing and mode of delivery after cesarean with previous classical incision or myomectomy: a review of the data. Semin Perinatol. 2011;35(5):257-61. https://doi.org/10.1053/j.semperi.2011.05.008
  • Rossi AC, Prefumo F. Pregnancy outcomes of induced labor in women with previous cesarean section: a systematic review and meta-analysis. Arch Gynecol Obstet. 2015;291(2):273-80. https://doi.org/10.1007/s00404-014-3444-9
  • Roberge S, Chaillet N, Boutin A, et al. Single- versus double-layer closure of the hysterotomy incision during cesarean delivery and risk of uterine rupture. Int J Gynaecol Obstet. 2011;115(1):5-10. https://doi.org/10.1016/j.ijgo.2011.04.013
  • National Institutes of Health Consensus Development conference statement: vaginal birth after cesarean: new insights March 8-10, 2010. Obstet Gynecol. 2010;115(6):1279-95. https://doi.org/10.1097/aog.0b013e3181e459e5
  • Wen SW, Huang L, Liston R, et al. Severe maternal morbidity in Canada, 1991-2001. CMAJ. 2005;173(7):759-64. https://doi.org/10.1503/cmaj.045156
  • Jansa V, Laganà AS, Ferrari F, et al. Uterine rupture in pregnancy after hysteroscopic septum resection: a 20-year retrospective analysis. Minim Invasive Ther Allied Technol. 2022;31(3):448-55. https://doi.org/10.1080/13645706.2020.1837884
There are 9 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Case Report
Authors

Ayşe Gizem Yıldız 0009-0001-6332-6724

Kübra Dilbaz 0000-0002-0592-7644

Publication Date September 26, 2024
Submission Date July 23, 2024
Acceptance Date August 12, 2024
Published in Issue Year 2024

Cite

APA Yıldız, A. G., & Dilbaz, K. (2024). A Case of Spontaneous Uterine Fundus Rupture in Term Pregnancy: As A Risk Factor of Septum Resection Operation. Türk Kadın Sağlığı Ve Neonatoloji Dergisi, 6(3), 105-109. https://doi.org/10.46969/EZH.1520857
AMA Yıldız AG, Dilbaz K. A Case of Spontaneous Uterine Fundus Rupture in Term Pregnancy: As A Risk Factor of Septum Resection Operation. Türk Kadın Sağlığı ve Neonatoloji Dergisi. September 2024;6(3):105-109. doi:10.46969/EZH.1520857
Chicago Yıldız, Ayşe Gizem, and Kübra Dilbaz. “A Case of Spontaneous Uterine Fundus Rupture in Term Pregnancy: As A Risk Factor of Septum Resection Operation”. Türk Kadın Sağlığı Ve Neonatoloji Dergisi 6, no. 3 (September 2024): 105-9. https://doi.org/10.46969/EZH.1520857.
EndNote Yıldız AG, Dilbaz K (September 1, 2024) A Case of Spontaneous Uterine Fundus Rupture in Term Pregnancy: As A Risk Factor of Septum Resection Operation. Türk Kadın Sağlığı ve Neonatoloji Dergisi 6 3 105–109.
IEEE A. G. Yıldız and K. Dilbaz, “A Case of Spontaneous Uterine Fundus Rupture in Term Pregnancy: As A Risk Factor of Septum Resection Operation”, Türk Kadın Sağlığı ve Neonatoloji Dergisi, vol. 6, no. 3, pp. 105–109, 2024, doi: 10.46969/EZH.1520857.
ISNAD Yıldız, Ayşe Gizem - Dilbaz, Kübra. “A Case of Spontaneous Uterine Fundus Rupture in Term Pregnancy: As A Risk Factor of Septum Resection Operation”. Türk Kadın Sağlığı ve Neonatoloji Dergisi 6/3 (September 2024), 105-109. https://doi.org/10.46969/EZH.1520857.
JAMA Yıldız AG, Dilbaz K. A Case of Spontaneous Uterine Fundus Rupture in Term Pregnancy: As A Risk Factor of Septum Resection Operation. Türk Kadın Sağlığı ve Neonatoloji Dergisi. 2024;6:105–109.
MLA Yıldız, Ayşe Gizem and Kübra Dilbaz. “A Case of Spontaneous Uterine Fundus Rupture in Term Pregnancy: As A Risk Factor of Septum Resection Operation”. Türk Kadın Sağlığı Ve Neonatoloji Dergisi, vol. 6, no. 3, 2024, pp. 105-9, doi:10.46969/EZH.1520857.
Vancouver Yıldız AG, Dilbaz K. A Case of Spontaneous Uterine Fundus Rupture in Term Pregnancy: As A Risk Factor of Septum Resection Operation. Türk Kadın Sağlığı ve Neonatoloji Dergisi. 2024;6(3):105-9.