Late Presentation of Uterine Rupture Following Vaginal Birth After Cesarean Delivery: A Case Report
| Autor: | Choi, Lindsey A., Chung, Ariel A., Pierce, Brian |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Uterus Case Report lcsh:Gynecology and obstetrics Adnexal mass 03 medical and health sciences 0302 clinical medicine Laparotomy medicine Hysterotomy Hemoperitoneum trial of labor after cesarean lcsh:RG1-991 uterine rupture 030219 obstetrics & reproductive medicine obstetrical emergency business.industry Ultrasound Obstetrics and Gynecology medicine.disease Uterine rupture Surgery medicine.anatomical_structure vaginal birth after cesarean 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health uterine dehiscence medicine.symptom business Postpartum period |
| Zdroj: | American Journal of Perinatology Reports, Vol 10, Iss 03, Pp e300-e303 (2020) AJP Reports |
| ISSN: | 2157-7005 2157-6998 |
| DOI: | 10.1055/s-0040-1715175 |
| Popis: | Background A trial of labor after cesarean delivery is associated with uterine rupture rates of 0.5 to 0.9%, which can have devastating neonatal and maternal consequences. While uterine rupture typically occurs during labor, it can clinically manifest after delivery. Case A 23-year-old multiparous female presented in labor at term. Her obstetrical history was significant for a prior low transverse cesarean delivery. She had an uncomplicated labor course and spontaneous vaginal delivery.Immediately after delivery, she complained of severe right shoulder and left lower quadrant pain. Bedside ultrasound revealed a 10-cm, complex, adnexal mass adjacent to the uterus without free fluid. She was hemodynamically stable and appeared clinically well. On repeat ultrasound, the mass was unchanged; however, the patient now had free intraperitoneal fluid along the liver edge.Emergent laparotomy revealed a uterine rupture along her prior hysterotomy with extension into the right uterine artery. A 10-cm broad ligament hematoma ruptured posteriorly resulting in a 1-L hemoperitoneum. She received multiple blood products intraoperatively and recovered well postpartum. Conclusion Delivery after trial of labor after cesarean delivery usually decreases acuity; however, these patients remain at risk for significant complications. Clinicians should continue to assess patients in the immediate postpartum period and proceed with surgical intervention if necessary. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|