Uterine rupture following laparoscopic salpingectomy- A rare case scenario

Dr.G.Susmitha; Dr.K.Prabhadevi

Volume : VIII, Issue : X, October - 2019

Uterine rupture following laparoscopic salpingectomy- A rare case scenario

Dr. G. Susmitha, Dr. K. Prabhadevi

Abstract :

INTRODUCTION: Uterine rupture is an obstetric emergency accounting for 3% of total maternal deaths. Most common cause is giving way of a previous cesarean or hysterotomy scar. The incidence of rupture uterus following laparoscopic surgeries is extremely low. CASE DETAILS: A 25year old, gravida 2, para 0, at 24+2 weeks of gestation, was ought to the emergency department with abdominal pain of sudden onset. She conceived 2months after laparoscopic salpingectomy, which was done in v/o cornual ectopic pregnancy. Ultrasound revealed uterine rupture and an emergency laparotomy was done. The entire amniotic sac was found in the peritoneal cavity with a rupture of the lateral wall of the uterus. Fetus delivered out, and uterus repaired in layers. Postoperative recovery was uneventful. DISCUSSION: Complete uterine rupture is defined as a nonsurgical disruption of all the layers of uterus. A case report of Nishijima Y et al. on Uterine rupture at 26 weeks of pregnancy following laparoscopic salpingectomy emphasizes the importance of regular follow up of pregnant patients with prior uterine surgery. CONCLUSION: Surgeons should ensure strict training of laparoscopic suture skills, limit the use of energy equipment, and ensure effective hemostasis by suturing and close the uterine defect with enough layers. Long term follow up of patients treated for cornual pregnancy with endometrial involvement is necessary.