Display options
Share it on

Cases J. 2009 Jun 03;2:7966. doi: 10.1186/1757-1626-2-7966.

Delayed diagnosis of an atypical rupture of an unscarred uterus due to assisted fundal pressure: a case report.

Cases journal

Mertihan Kurdoglu, Ali Kolusari, Recep Yildizhan, Ertan Adali, Hanim Guler Sahin

Affiliations

  1. Department of Obstetrics and Gynecology, Yuzuncu Yil University School of Medicine Van Turkey. [email protected]

PMID: 19830029 PMCID: PMC2740166 DOI: 10.1186/1757-1626-2-7966

Abstract

INTRODUCTION: Although rare, rupture of an unscarred uterus is one of the most dangerous obstetric complications, resulting in maternal and fetal jeopardy.

CASE PRESENTATION: A 30-year-old grand multiparous Turkish woman without any history of uterine surgery gave birth vaginally at 37 weeks of gestation with fundal pressure applied in the second stage of labor. Transabdominal sonography performed 32 hours after delivery due to postural hypotension and a drop in hemoglobin values in the postpartum period revealed massive intra-abdominal free fluid. On emergency laparotomy, serosal rupture of the uterus on the left posterior side was observed. She underwent a subtotal hysterectomy and did well postoperatively.

CONCLUSION: Postural hypotension in postpartum patients without any evident vaginal bleeding may be an early sign of possible uterine rupture, even if the vital signs are stable. Early diagnosis is important if maternal morbidity and mortality are to be decreased.

References

  1. Hum Reprod. 2000 May;15(5):1198-9 - PubMed
  2. Emerg Radiol. 2006 May;12(4):186-8 - PubMed
  3. Taiwan J Obstet Gynecol. 2006 Jun;45(2):170-2 - PubMed
  4. Med Trop (Mars). 2002;62(6):615-8 - PubMed
  5. MCN Am J Matern Child Nurs. 2001 Mar-Apr;26(2):64-70; quiz 71 - PubMed
  6. Am J Obstet Gynecol. 1995 Jun;172(6):1851-5; discussion 1855-6 - PubMed
  7. Semin Fetal Neonatal Med. 2006 Jun;11(3):150-7 - PubMed
  8. J Reprod Med. 2002 Dec;47(12):1044-6 - PubMed
  9. Hum Reprod. 1997 Sep;12(9):2066-7 - PubMed
  10. Obstet Gynecol Surv. 2005 Sep;60(9):599-603 - PubMed

Publication Types