A clinical case of the uterine complete rupture along with the previous scar during pregnancy with atypical clinical features
- Authors: Mochalova M.N.1, Mudrov V.A.1, Alexeyeva A.Y.1, Kuzmina L.A.2
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Affiliations:
- Chita State Medical Academy
- Regional Clinical Hospital
- Issue: Vol 70, No 5 (2021)
- Pages: 141-146
- Section: Theory and Practice
- URL: https://journals.eco-vector.com/jowd/article/view/63471
- DOI: https://doi.org/10.17816/JOWD63471
- ID: 63471
Cite item
Abstract
This article presents an unusual case of rupture of the scarred uterus at 36-37 weeks of gestation. The patient presented with pain in the pubic and hip joint area, growing stronger while her walking, seated and changing position. No clinical manifestations of hemorrhagic shock were observed. External obstetric examination revealed a normotonic uterus and satisfactory fetus condition. Provocation tests were conducted to exclude subluxation of the pubic joint. Pubic symphysis diastasis palpation, long dorsal sacroiliac ligament palpation, P4 test, Patrick’s test, and the modified Trendelenburg test were negative. Pelvic examination revealed sharp pain in lower uterus segment. Ultrasound scan revealed deformation and thinning of the scar up to 1 mm, and no abnormalities in pubic symphysis. A threatening uterine rupture was diagnosed, and emergency cesarean section was performed. Intraoperative examination showed that the scar located in the lower segment consisted of connective tissue. In addition, there was a 4 × 5 cm scar defect with the overlying amniotic sac, no hemorrhage being noted. After removing the fetus, scar excision was performed. The uterine defect was repaired with a double layer running-locking suture. The patient was discharged from hospital on day 5 of postpartum period. The infant was exposed in the neonatal intensive care unit to provide an early developmental care.
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About the authors
Marina N. Mochalova
Chita State Medical Academy
Email: marina.mochalova@gmail.com
ORCID iD: 0000-0002-5941-0181
MD, Cand. Sci. (Med.), Assistant Professor
Russian Federation, ChitaViktor A. Mudrov
Chita State Medical Academy
Email: mudrov_viktor@mail.ru
ORCID iD: 0000-0002-5961-5400
Scopus Author ID: 57204736023
MD, Cand. Sci. (Med.), Assistant Professor
Russian Federation, ChitaAnastasia Yu. Alexeyeva
Chita State Medical Academy
Author for correspondence.
Email: mironenkoanastasia4@gmail.ru
ORCID iD: 0000-0001-5061-8026
MD
Russian Federation, ChitaLyubov A. Kuzmina
Regional Clinical Hospital
Email: prostopochta1804@mail.ru
ORCID iD: 0000-0003-2035-7966
MD
Russian Federation, ChitaReferences
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