Korean J Obstet Gynecol.  2010 Aug;53(8):732-736. 10.5468/kjog.2010.53.8.732.

Spontaneous uterine rupture during early labor in term pregnancy after laparoscopic radiofrequency myolysis

• Hwang EJ
• Kim SM
• Jun JK

• KMID: 2273992
• DOI: http://doi.org/10.5468/kjog.2010.53.8.732

Abstract

Spontaneous uterine rupture is a rare occurrence, but a catastrophic obstetric complication, associated with high rates of maternal and perinatal morbidity and mortality. Clinicians should make a prompt diagnosis and management in patients presenting with acute abdominal pain, hypovolemic shock, and fetal compromise. We present a case of spontaneous complete rupture of uterus during early labor in term pregnancy after laparoscopic radiofrequency myolysis.

Keyword

Uterine rupture; Myolysis; Term pregnancy

MeSH Terms

Abdominal Pain
Humans
Pregnancy
Rupture
Shock
Uterine Rupture
Uterus

Figure

• 

  Fig. 1 Amniotic sac and hematoma that was exposed directly after entering abdominal cavity.

• 

  Fig. 2 Placenta located in posterior cul-de-sac.

• 

  Fig. 3 Longitudinal uterine rupture with an empty uterine cavity.

• 

  Fig. 4 Operative findings showing repaired uterus.

Reference

1. Walsh CA, Baxi LV. Rupture of the primigravid uterus: a review of the literature. Obstet Gynecol Surv. 2007. 62:327–334.

2. Gardeil F, Daly S, Turner MJ. Uterine rupture in pregnancy reviewed. Eur J Obstet Gynecol Reprod Biol. 1994. 56:107–110.

3. Ofir K, Sheiner E, Levy A, Katz M, Mazor M. Uterine rupture: risk factors and pregnancy outcome. Am J Obstet Gynecol. 2003. 189:1042–1046.

4. Miller DA, Goodwin TM, Gherman RB, Paul RH. Intrapartum rupture of the unscarred uterus. Obstet Gynecol. 1997. 89:671–673.

5. Sweeten KM, Graves WK, Athanassiou A. Spontaneous rupture of the unscarred uterus. Am J Obstet Gynecol. 1995. 172:1851–1855.

6. Dilip V, Stephen G, Alfred S. Review of the conservative surgical treatment of uterine fibroids. Review in Gynecol Prac. 2004. 4:20–26.

7. Nisolle M, Smets M, Malvaux V, Anaf V, Donnez J. Laparoscopic myolysis with the Nd:YAG laser. J Gynecol Surg. 1993. 9:95–99.

8. Ghezzi F, Cromi A, Bergamini V, Scarperi S, Bolis P, Franchi M. Midterm outcome of radiofrequency thermal ablation for symptomatic uterine myomas. Surg Endosc. 2007. 21:2081–2085.

9. Hwang IT, Rho JH, Kim KH. Transvaginal radiofrequency myolysis for conservative management of uterine myomas. Korean J Obstet Gynecol. 2007. 50:337–344.

10. Vilos GA, Daly LJ, Tse BM. Pregnancy outcome after laparoscopic electromyolysis. J Am Assoc Gynecol Laparosc. 1998. 5:289–292.

11. Arcangeli S, Pasquarette MM. Gravid uterine rupture after myolysis. Obstet Gynecol. 1997. 89:857.

12. Nkemayim DC, Hammadeh ME, Hippach M, Mink D, Schmidt W. Uterine rupture in pregnancy subsequent to previous laparoscopic electromyolysis. Case report and review of the literature. Arch Gynecol Obstet. 2000. 264:154–156.

13. Kim JW, Kim TH, Kim SM, Yoon JM, Lim HS, Park CW, et al. Spontaneous uterine rupture during second trimester. Korean J Obstet Gynecol. 2009. 52:91–95.

14. Kim SM, Kim GH, Jung DU, Se EJ, Moon JK, Song JE, et al. A case of uterine rupture in IUP 15+1weeks following previous myolysis. Korean J Obstet Gynecol. 2009. 52:945–949.

15. Donnez J, Squifflet J, Polet R, Nisolle M. Laparoscopic myolysis. Hum Reprod Update. 2000. 6:609–613.

16. Istre O. Management of symptomatic fibroids: conservative surgical treatment modalities other than abdominal or laparoscopic myomectomy. Best Pract Res Clin Obstet Gynaecol. 2008. 22:735–747.

17. Lee JJ, Choi JB, Park EH, Kim MK, Lee IS. Minimal invasive treatment of uterine myoma: Laparoscopic radiogrequency myolysis. Korean J Obstet Gynecol. 2006. 49:1212–1218.

18. Rye JH, Kim KH, Park JS, Yang YS, Oh KY, Rho JH, et al. Comparative analysis on the effectiveness of transvaginal radiofrequency myolysis for conservative management of leiomyoma and adenomyosis. Korean J Obstet Gynecol. 2008. 51:48–59.

19. Lim AC, Kwee A, Bruinse HW. Pregnancy after uterine rupture: a report of 5 cases and a review of the literature. Obstet Gynecol Surv. 2005. 60:613–617.

20. Usta IM, Hamdi MA, Musa AA, Nassar AH. Pregnancy outcome in patients with previous uterine rupture. Acta Obstet Gynecol Scand. 2007. 86:172–176.