Second Trimester Uterine Ruptures: Case Reports

Öz

Despite modern obstetric developments, uterine rupture is an important obstetric complication causing maternal and fetal morbidity and mortality. The most common cause of uterine rupture is cesarean section in developed countries,,and in other countries the most common cause is difficult births. Uterine rupture symptoms and findings are non-specific. Abdominal pain, vaginal bleeding, and abnormal fetal heart rate cardiotocographic findings are uterine rupture findings. We aimed to present cases of uterine rupture detected in the second trimester, which may delayed diagnosis in if not suspected. Ultrasonographic evaluation of the uterus, with clinical findings in cases of risk for uterine rupture, will facilitate recognition. We decide treatment on maternal and fetal condition, amount of bleeding and future fertilization status.

Anahtar Kelimeler

• Uterine rupture,caesarean scar pregnancy,risky pregnancy

İkinci Trimesterda Tespit Edilen Uterus Rüptürleri: Olgu Serisi

Öz

Modern obstetrik gelişmelere rağmen, uterus rüptürü anne ve fetüs için morbidite ve mortaliliteye neden olan önemli bir obstetrik komplikasyondur. Gelişmiş ülkelerde uterus rüptürünün başlıca nedenleri arasında geçirilmiş sezaryen öyküsü iken, gelişmekte olan ülkelerde ise, zorlu doğumlar gelmektedir. Uterus rüptürünün semptom ve bulguları non-spesifiktir. Abdominal ağrı, vajinal kanama ve kardiyotokografide fetal kalp hızı anormallikleri uterus rüptürünü düşündüren belirtilerdir. İkinci trimesterde tespit edilen, şüphelenilmediğinde erken tanının gecikebileceği, uterus rüptürü olgularını literatür eşliğinde sunmayı amaçladık. Uterus rüptürü için risk grubunda olan olgularda klinik bulgular ile birlikte, uterusun ultrasonografik olarak değerlendirilmesi tanıyı kolaylaştıracaktır. Tedaviye karar verirken; annenin ve fetüsün durumu, kanama miktarı ve gelecekteki fertilizasyon durumu da göz önünde bulundurulmalıdır.

Anahtar Kelimeler

• Uterin rüptür,sezaryen skar gebeliği,riskli gebelik

Kaynakça

1. Hofmeyr GJ, Say L, Gülmezoglu. WHO systematic review of maternal mortality and morbidity: the prevalence of uterine rupture.AM BJOG. 2005; 112:1221-8
2. Zeteroglu S, Ustun Y, Engin-Ustun Y, Sahin HG, Kamaci M. Eight years’ experience of uterine rupture cases. J Obstet Gynaecol 2005;25:458-61.
3. Phillips JA. Ruptured uterus in Mulanje CCAP Hospital, 1974-1982. Trop Doct. 1990; 20:175-6.
4. Kurdoglu M, Kolusari A, Yildizhan R, Adali E, Sahin HG. Delayed diagno- sis of an atypical rupture of an unscarred uterus due to assisted fundal pressure: a case report. Cases J. 2009;2:7966.
5. Damiani GR, Gaetani M, Landi S, Lacerenza L, Barnaba M, Spellecchia D, Pellegrino A. Uterine rupture in a nulliparous woman with septate uterus of the second trimester pregnancy and review in literature. Int J Surg Case Rep. 2013;4:259-61
6. Revicky V, Muralidhar A, Mukhopadhyay S, Mahmood T. A Case Series of Uterine Rupture: Lessons to be Learned for Future Clinical Practice. J Obstet Gynaecol India. 2012;62:665-73.
7. Landon MB, Spong CY, Thom E, et al. Risk of uterine rupture with a trial of labor in women with multiple and single prior cesarean delivery. Obstet Gynecol. 2006;108:12–20.
8. Kim MS, Uhm YK, Kim JY, Jee BC, Kim YB. Obstetric outcomes after ute- rine myomectomy: Laparoscopic versus laparotomic approach. Obstet Gynecol Sci. 2013;56:375–381.

9. Guiliano M, Closset E, Therby D, LeGoueff F, Deruelle P, Subtil D. Sig- ns, symptoms and complications of complete and partial uterine rup- tures during pregnancy and delivery. Eur J Obstet Gynecol Reprod Biol 2014;179:130–4.
10. Rozenberg P, Goffinet F, Phillippe HJ, Nisand I. Ultrasonographic mea- surement of lower uterine segment to assess risk of defects of scarred uterus. Lancet 1996; 347: 281–284.
11. Martins WP, Barra DA, Gallarreta FM, Nastri CO, Filho FM. Conservative management of uterine rupture diagnosed prenatally on the basis of so- nography. Ultrasound Obstet Gynecol. 2009;33:301-6.
12. Rathod S, Samal SK, Swain S. A Three Year Clinicopathological Study of Cases of Rupture Uterus. J Clin Diagn Res. 2015;9:4-6.
13. Sahu L. A 10 year analysis of uterine rupture at a teaching institution. J Obstet Gynaecol India. 2006;56:502–06.
14. Wani RV, Abu-Hudra NM, Al-Tahir SI. Emergency peripartum hysterec- tomy: a 13-year review at a tertiary center in kuwait. J Obstet Gynaecol India. 2014;64:403-8.
15. Chawla J, Arora D, Paul M, Ajmani SN. Emergency Obstetric Hysterec- tomy: A Retrospective Study from a Teaching Hospital in North India over Eight Years. Oman Med J. 2015;30:181-6.