Résumé
We describe a case of recurrent uterine rupture at the site of a previous rupture. Our patient had a history of right interstitial pregnancy with spontaneous uterine fundal rupture at 18 weeks of pregnancy. During her subsequent pregnancy, she was monitored closely by a senior consultant obstetrician. The patient presented at 34 weeks with right hypochondriac pain. She was clinically stable and fetal monitoring showed no signs of fetal distress. Ultrasonography revealed protrusion of the intact amniotic membranes in the abdominal cavity at the uterine fundus. Uterine rupture is a rare but hazardous obstetric complication. High levels of caution should be exercised in patients with a history of prior uterine rupture, as they may present with atypical symptoms. Ultrasonography could provide valuable information in such cases where there is an elevated risk of uterine rupture at the previous rupture site.
Sujets)
Adulte , Femelle , Humains , Nouveau-né , Grossesse , Douleur abdominale , Amnios , Imagerie diagnostique , Anatomopathologie , Laparotomie , Imagerie par résonance magnétique , Complications de la grossesse , Imagerie diagnostique , Issue de la grossesse , Récidive , Échographie , Rupture utérine , Imagerie diagnostique , Utérus , Imagerie diagnostique , AnatomopathologieRésumé
<p><b>INTRODUCTION</b>This study aimed to assess maternal and perinatal outcomes following second stage Caesarean sections.</p><p><b>METHODS</b>A retrospective study was conducted in a Singapore-based tertiary referral centre from January 1, 2009 to December 31, 2009. The medical records of all the women who underwent emergency Caesarean sections in the second stage of labour were reviewed.</p><p><b>RESULTS</b>Out of 2,501 emergency Caesarean sections performed, 116 were Caesarean sections in the second stage of labour. Women with non-vertex, twins and preterm deliveries were excluded, and 110 (4.4%, 110/2,501) Caesarean sections were recruited. The majority of the Caesarean sections were determined and performed by registrars or consultants. With regard to maternal outcome, 2.7% (3/110) of patients had primary postpartum haemorrhage and 4.5% (5/110) of patients had vertical or lateral lower uterine segment tears. As for neonatal outcome, although the Apgar scores of newborns were low at birth for 8.2% (9/110) of patients, the Apgar score was > 4 at 5 minutes for all patients.</p><p><b>CONCLUSION</b>Overall, there was no statistically significant adverse maternal or perinatal outcome.</p>