Recurrent uterine rupture in pregnancy after pelvic surgery

Abstract

Uterine rupture is a rare but life-threatening complication, for both the mother and the fetus. This event is usually linked to the presence of uterine scars which in the past were mainly caused by cesarean section surgery. Today the number of uterine surgeries has significantly increased and rupture events are now principally connected with laparoscopic myomectomy. We report the case of a patient with recurrent uterine rupture: the events occurred in two consecutive pregnancies. Years earlier, the woman had undergone laparoscopic myomectomy for removal of a single intramural myoma node. The first rupture event was an asymptomatic wall dehiscence discovered during an elective cesarean delivery for fetal breech presentation. The second happened during the third trimester of pregnancy and presented as a real emergency: in that case the patient suffered a complete uterine rupture and on ultrasound scan fetal parts were observed outside the uterine cavity in the abdomen.