Second trimester uterine rupture: lesson learned

• Main Authors: Abdulwahab, Dalia F, Ismail, Hamizah, Nusee, Zalina, Raja Ismail, Raja Arif Shah, M, Azam, Awang, Mokhtar, I, Roziah, Abd Rahman, Azlina, MS, Azrul
• Format: Article
• Language: English; English; English
• Published: Obstetrical & Gynaecological society of malaysia 2011
• Subjects: RG Gynecology and obstetrics
• Online Access: http://irep.iium.edu.my/31322/1/SECOND_TRIMESTER_UTERINE_RUPTURE_OGSM_IREP.pdf; http://irep.iium.edu.my/31322/4/dr_dalia.jpeg; http://irep.iium.edu.my/31322/5/second_trimester.jpeg; http://irep.iium.edu.my/31322/

Introduction: Uterine rupture is a rare obstetrics catastrophic especially if it occurs during early pregnancy. We experienced three cases of ruptured uterus in the second trimester that first line doctors and obstetrician could learn lessons from. Objectives: To study the presentations and outcome of uterine rupture in the second trimester. Methodology: A retrospective review of uterine rupture in Hospital Tengku Ampuan Afzan from the 1st of April 2010 to the 1st of April 2011. Data obtained from case records, histopathological and autopsy reports. Result: There were 3 cases of uterine rupture. First case, uterine rupture at 15 weeks post sexual intercourse, undiagnosed until postmortem. Second case: ruptured uterus at 24 week diagnosed at laparotomy with the indication of failed medical termination for fetal anomaly. Third case: ruptured uterus at 21 weeks following abdominal massage with initial diagnosis of acute gastroentritis. The final diagnosis was ruptured uterus secondary to placenta percreta, related to medical induction and interstitial pregnancy respectively. Conclusion: Rupture uterus should be considered with or without any risk factors regardless of the gestational age whenever any impression of hemoperitoneum. Intensive surgical method would be needed for accurate diagnosis and immediate management even in early pregnancy is a life saving.