RESUMEN
A spontaneous rupture of the unscarred uterus in a primigravid patient is extremely rare and is associated with high perinatal and maternal morbidity and mortality. Study report a case of spontaneous rupture of an unscarred uterus at 36 weeks of gestation in a 22-years primigravid woman. Ultrasonography showed posterior low-lying placenta praevia with lower margin touching internal OS. Operative findings during emergent caesarean section revealed e/o 2 L of hemoperitoneum, uterus was bicornuate and pregnancy was in the right horn. There was fundal rupture of right horn measuring approximately 6-7 cm anteroposterior. Incision was taken on the lower part of right horn and placenta was seen on anterior wall. Baby delivered as breech after incising placenta. Postoperative recovery was uneventful. In, conclusion, bicornuate uterus may be an independent risk factor for uterine rupture, which can occur in primigravid patients and at any gestation.
RESUMEN
Introduction: Placenta previa complicates 0.3–0.5% of all pregnancies and is a major cause of third-trimester hemorrhage. Itaffects both mother and fetus; therefore, it is important to study this condition and its complications.Aims and Objectives: The aims and objectives of this study were to compare the incidence of placenta previa, associated factors,complications, placental position, mode of delivery, and fetal and maternal outcome in non-scarred uterus and scarred uterus.Materials and Methods: A total of 100 patients identified with the diagnosis of placenta previa beyond 28 weeks of gestationwere taken. The cases were divided into two groups: Scarred and unscarred. Both the groups were compared for parameterssuch as maternal age, parity, frequency of placenta previa, fetal outcome, operative procedures, and maternal morbidity andmortality.Results: Of 100 patients, 23% were in the age group between 18 and 25, 49% between 26 and 30, and 28% between 31 and40 years. 6% of patients in scarred uterus had 2 or more previous dilatation and curettage. In all patients of scarred uterus, 80%of the patients had previous 1 cesarean section, while 15% had two previous sections and 4.5% had previous three cesareansections. Chances of placenta previa increase both with dilatation and curettage and previous cesarean sections. However, itwas found in this study that fetal outcome did not differ much with the presence of scarred uterus.Conclusion: It can be concluded that, in our study, the cesarean section had a significant relationship with placenta previa andthis risk becomes very high with escalation in number of cesarean sections.
RESUMEN
Uterine rupture is usually associated with previous uterine scar. Although intrapartum rupture of unscarred uterus is very rare, it may cause catastrophic outcomes to both the mother and the newborn infant compared with that of a scarred uterus. The present case describes our experience of anesthesia for an emergency cesarean section due to the arrest of fetal descent in a 36-year-old parturient who had undergone external cephalic version for the breech presentation of her fetus. We detected the rupture of her unscarred uterus during the operation under epidural anesthesia, which was changed to general anesthesia. Despite the uterine rupture the newborn infant survived uneventfully. At the postoperative twelfth day she was discharged from hospital with her baby.