Uterine preservation in a woman with spontaneous uterine rupture secondary to placenta percreta on the posterior wall: A case report

Le Ming Wang, Peng Hui Wang, Chi-Long Chen, Heng-Kien Au, Yuan Kuei Yen, Wei-Min Liu

研究成果: 雜誌貢獻文章

17 引文 斯高帕斯(Scopus)

摘要

Several cases in which uteruses have been preserved in women with placenta percreta have been reported. We herein report a 38-year-old woman with a history of previous cesarean section who was admitted with lower abdominal pain and vaginal bleeding at 31 weeks of gestation. An urgent exploratory laparotomy revealed active bleeding from the uterine rupture on the posterior uterine wall. A female infant weighing 1560 g, with Apgar scores of 1, 1, and 3 at 1, 5, and 10 min, respectively, was delivered, and the placenta was removed. We performed bilateral uterine vessel occlusion, followed by wedge resection of the ruptured uterine wall with the aid of an intrauterine muscle injection of 20 IU oxytocin, a local injection of diluted vasopressin (1:60) into the myometrium around and into the rupture site, and an intramuscular injection of 0.2 mg methylergonovine, primary repair of the defect, and an additional 24-h postoperative oxytocin infusion (30 IU in 5% dextrose 500 mL) to preserve the uterus successfully. Although the overall blood loss was 3700 mL, no disseminated intravascular coagulopathy occurred after the patient had received adequate blood transfusion. The postoperative pathological diagnosis was placenta percreta with uterine rupture. The patient and her baby were discharged uneventfully. In some cases of spontaneous uterine rupture secondary to placenta percreta, we can preserve the uterus by performing bilateral uterine vessel occlusion and wedge resection of the ruptured uterine wall.
原文英語
頁(從 - 到)379-384
頁數6
期刊Journal of Obstetrics and Gynaecology Research
35
發行號2
DOIs
出版狀態已發佈 - 四月 2009

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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