First Trimester Uterine Rupture: A Case Report and Literature Review.


Journal

International journal of environmental research and public health
ISSN: 1660-4601
Titre abrégé: Int J Environ Res Public Health
Pays: Switzerland
ID NLM: 101238455

Informations de publication

Date de publication:
24 04 2020
Historique:
received: 27 03 2020
revised: 17 04 2020
accepted: 21 04 2020
entrez: 30 4 2020
pubmed: 30 4 2020
medline: 26 9 2020
Statut: epublish

Résumé

The aim is to report a case of spontaneous uterine rupture in the first trimester of pregnancy and to review the literature on the topic. A literature search was performed using PubMed and Scopus. Relevant English articles were identified without any time or study limitations. The data were aggregated, and a summary statistic was calculated. A 35-year-old gravida 5, para 2 was admitted at our department because of fainting and abdominal pain. The woman had a first-trimester twin pregnancy and a history of two previous cesarean sections (CSs). Suspecting a uterine rupture, an emergency laparotomy was performed. The two sacs were completely removed, and the uterine rupture site was closed with a double-layer suture. The patient was discharged from hospital four days later in good condition. On the basis of this experience, a total of 76 case reports were extracted from PubMed and included in the review. Fifty-three patients out of 76 (69.74%) underwent previous surgery on the uterus. Most women (67.92%) had a CS, and in this group a cesarean scar pregnancy (CSP) or a placenta accreta spectrum (PAS) disorder was found to be the etiology in 77.78% of cases. Furthermore, 35.85% of the women had hysterectomy after uterine rupture. Twenty-three patients out of 76 (30.26%) had an unscarred uterus. Of this group, most women presented a uterine anomaly (43.48%). Moreover, 17.39% of these women had a hysterectomy. According to the literature, the current pandemic use of CS explains most cases of first-trimester uterine rupture.

Identifiants

pubmed: 32344763
pii: ijerph17082976
doi: 10.3390/ijerph17082976
pmc: PMC7215710
pii:
doi:

Types de publication

Case Reports Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

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Auteurs

Fabiana Cecchini (F)

Department of Gynecology and Obstetrics, School of Medicine of Udine, 33100 Udine, Italy.

Alice Tassi (A)

Department of Gynecology and Obstetrics, School of Medicine of Udine, 33100 Udine, Italy.

Ambrogio P Londero (AP)

Department of Gynecology and Obstetrics, School of Medicine of Udine, 33100 Udine, Italy.

Giovanni Baccarini (G)

Department of Gynecology and Obstetrics, School of Medicine of Udine, 33100 Udine, Italy.

Lorenza Driul (L)

Department of Gynecology and Obstetrics, School of Medicine of Udine, 33100 Udine, Italy.

Serena Xodo (S)

Department of Gynecology and Obstetrics, School of Medicine of Udine, 33100 Udine, Italy.

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Classifications MeSH