First Trimester Uterine Rupture: A Case Report and Literature Review

Fabiana Cecchini, Alice Tassi, Ambrogio P. Londero, Giovanni Baccarini, Lorenza Driul and Serena Xodo
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Fabiana Cecchini: Department of Gynecology and Obstetrics, School of Medicine of Udine, 33100 Udine, Italy
Alice Tassi: Department of Gynecology and Obstetrics, School of Medicine of Udine, 33100 Udine, Italy
Ambrogio P. Londero: Department of Gynecology and Obstetrics, School of Medicine of Udine, 33100 Udine, Italy
Giovanni Baccarini: Department of Gynecology and Obstetrics, School of Medicine of Udine, 33100 Udine, Italy
Lorenza Driul: Department of Gynecology and Obstetrics, School of Medicine of Udine, 33100 Udine, Italy
Serena Xodo: Department of Gynecology and Obstetrics, School of Medicine of Udine, 33100 Udine, Italy

IJERPH, 2020, vol. 17, issue 8, 1-13

Abstract: The aim is to report a case of spontaneous uterine rupture in the first trimester of pregnancy and to review the literature on the topic. Methods: A literature search was performed using PubMed and Scopus. Relevant English articles were identified without any time or study limitations. The data were aggregated, and a summary statistic was calculated. Results: A 35-year-old gravida 5, para 2 was admitted at our department because of fainting and abdominal pain. The woman had a first-trimester twin pregnancy and a history of two previous cesarean sections (CSs). Suspecting a uterine rupture, an emergency laparotomy was performed. The two sacs were completely removed, and the uterine rupture site was closed with a double-layer suture. The patient was discharged from hospital four days later in good condition. On the basis of this experience, a total of 76 case reports were extracted from PubMed and included in the review. Fifty-three patients out of 76 (69.74%) underwent previous surgery on the uterus. Most women (67.92%) had a CS, and in this group a cesarean scar pregnancy (CSP) or a placenta accreta spectrum (PAS) disorder was found to be the etiology in 77.78% of cases. Furthermore, 35.85% of the women had hysterectomy after uterine rupture. Twenty-three patients out of 76 (30.26%) had an unscarred uterus. Of this group, most women presented a uterine anomaly (43.48%). Moreover, 17.39% of these women had a hysterectomy. Conclusion: According to the literature, the current pandemic use of CS explains most cases of first-trimester uterine rupture.

Keywords: first trimester; uterine rupture; cesarean section (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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