Pregnancy Following Spontaneous Healing Of Uterine Rupture: A Case Report And Experience Of Management
Sugai, S., Haino, K., Yamawaki, K., Yoshihara, K., & Nishijima, K. (2024). Pregnancy Following Spontaneous Healing of Uterine Rupture: A Case Report and Experience of Management. Cureus, 16(9), e70322. https://doi.org/10.7759/cureus.70322
View Original Source →Abstract
Uterine rupture can heal naturally without the need for surgical intervention. However, reports on subsequent pregnancies are limited. A 27-year-old woman, gravida 2, para 1, visited our institution at seven weeks of gestation. She had previously experienced uterine rupture with postpartum hemorrhage, which had healed naturally without surgical intervention. We thoroughly explained the perinatal complications associated with the subsequent pregnancy, particularly the risk of uterine rupture recurrence, and managed her pregnancy progress carefully. We took great care to ensure that signs of a silent rupture were not missed on imaging examinations. A planned cesarean delivery was performed at 35 weeks of gestation, resulting in an uneventful pregnancy outcome. We report the details of our management of a subsequent pregnancy in a woman who had previously experienced uterine rupture with natural healing. Our findings may serve to support healthcare providers managing similar cases.
Case Details
Disease Location
Uterus
Personal Characteristics
27-year-old, gravida 2, para 1, woman
Clinical Characteristics
Referred at seven weeks of gestation for high-risk pregnancy management. She had previously experienced uterine rupture with postpartum hemorrhage, with further spontaneous healing. MRI revealed thinning on the left side of the lower uterus and a uterine rupture scar. At 15 months after the delivery, she conceived naturally. Transvaginal ultrasound revealed a single viable fetus that was growing appropriately. The uterine rupture scar was indistinct. Ultrasound was performed weekly, and an MRI was conducted at 24 and 31 weeks of gestation to check for silent rupture. Localized thinning of the myometrium was observed on the lower left side of the uterus, but there were no signs of re-rupture. The locations of the placenta and scar were confirmed. Cesarean deilvery was performed at 35.5 weeks of gestation
Remission Characteristics
During the surgery, identification of the uterine rupture scar was difficult
Treatment & Mechanisms
Proposed Remission Mechanisms
Uterine rupture can heal spontaneously without the need for surgical intervention.
Clinical Treatment
C-section
Non-Clinical Treatment
None reported