A case of spontaneous uterine rupture discovered during a cesarean section after a laparoscopic adenomyomectomy and literature review

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  • MASUDA Masamune
    Department of Obstetrics and Gynecology, Japanese Red Cross Kyoto Daini Hospital
  • KATOH Seiko
    Department of Obstetrics and Gynecology, Japanese Red Cross Kyoto Daini Hospital
  • KURIHARA Koki
    Department of Obstetrics and Gynecology, Japanese Red Cross Kyoto Daini Hospital
  • FUKUYAMA Mari
    Department of Obstetrics and Gynecology, Japanese Red Cross Kyoto Daini Hospital
  • ASANO Shota
    Department of Obstetrics and Gynecology, Japanese Red Cross Kyoto Daini Hospital
  • YAMAMOTO Aya
    Department of Obstetrics and Gynecology, Japanese Red Cross Kyoto Daini Hospital
  • ETOH Miho
    Department of Obstetrics and Gynecology, Japanese Red Cross Kyoto Daini Hospital
  • FUJITA Hiroyuki
    Department of Obstetrics and Gynecology, Japanese Red Cross Kyoto Daini Hospital

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Other Title
  • 帝王切開術中に子宮破裂を確認した腹腔鏡下子宮腺筋症核出術後妊娠の1例と文献的考察
  • 症例報告 帝王切開術中に子宮破裂を確認した腹腔鏡下子宮腺筋症核出術後妊娠の1例と文献的考察
  • ショウレイ ホウコク テイオウ セッカイ ジュッチュウ ニ シキュウ ハレツ オ カクニン シタ フククウキョウ カ シキュウセンキンショウカクシュツジュツゴ ニンシン ノ 1レイ ト ブンケンテキ コウサツ

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Abstract

<p>Although the popularity of adenomyomectomy as an infertility treatment is increasing, uterine rupture following conception has been reported as a postoperative complication of this procedure. We describe a case of spontaneous uterine rupture discovered during a cesarean section after a laparoscopic adenomyomectomy. A 39-year-old woman (gravida 1, para 0) underwent laparoscopic adenomyomectomy to preserve fertility, and 5 months later, she conceived through IVF-ET. However, she had placenta previa in the second trimester of the pregnancy and was referred to our department at 30 weeks of gestation. Magnetic resonance imaging performed at 33 weeks of gestation demonstrated placenta previa posteriorly and myometrial thinning in the uterine fundus. Because of threatened uterine rupture, we prepared for surgery. An elective cesarean section was performed at 35 weeks of gestation. Because a uterine rupture (five cm in diameter) was found in the uterine fundus where there was a scar from the previous adenomyomectomy, we decided to do a total hysterectomy. After the surgery, the puerperal and neonatal courses were uneventful. Because women who become pregnant after an adenomyomectomy have a high risk of uterine rupture, they should be cautious throughout pregnancy. [Adv Obstet Gynecol, 71(2) : 116-122, 2019 (R1.5)]</p>

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