A case of successful delivery in a patient with a complete uterine rupture in previous pregnancy after laparoscopic myomectomy and hysteroresectoscopy


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Abstract

Background. Current gynecological practice shows a steady increase in the number of endoscopic surgeries for uterine myoma in reproductive-aged women. So the number of women with the operated uterus is increasing everywhere. In future, this will inevitably present a problem of uterine scar competence during pregnancy and labor. Description of clinical case. This clinical example shows that women who have sustained a uterine rupture during previous pregnancy may have a favorable course of subsequent pregnancy and a favorable labor outcome. In the given case, the cause of the complete uterine rupture accompanied by severe hemorrhagic shock and antenatal fetal death was postoperative uterine scar incompetence. The patient has a history of a large number of uterine myoma surgeries (hysteroresectoscopy, laparoscopic myomectomy, and uterine artery embolization). Conclusion. Organ-sparing surgery for uterine rupture during pregnancy and labor is the method of choice particularly in young women who have not realized their reproductive function. Pregnancy management in these patients should contemplate careful antenatal care, automatic check of the uterine scar, and planned delivery at third-level hospitals.

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About the authors

Vitaliy B. Tskhai

Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: tchai@yandex.ru
M.D., professor, Head of the Department of Perinatology, Obstetrics and Gynecology, Medical Faculty

Tatiana A. Makarenko

Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: makarenko7777@yandex.ru
M.D., docent, Head of the Department of operative gynecology, Institute of postgraduate education

Inga O. Ulyanova

Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: inga_ulyanova@mail.ru
docent of the Department of operative gynecology, Institute of postgraduate education

Daria E. Nikiforova

Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: dashsemch@mail.ru
assistant of the Department of Perinatology, Obstetrics and Gynecology Medical Faculty

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