Umbilical cord prolapse through urethra due to complicated uterine rupture
DOI:
https://doi.org/10.2478/AMB-2024-0026Keywords:
umbilical cord prolapse, uterine rupture, preeclampsiaAbstract
Uterine rupture is a rare but potentially fatal complication of pregnancy with life-threatening maternal and fetal consequences. We present a case of umbilical cord prolapsed through urethra due to complicated uterine rupture in a patient with severe preeclampsia. A multiparous woman in her 30s, with history of untreated preeclampsia during this pregnancy and two previous Cesarean sections presented with spontaneous leakage of amniotic fluid in a full-term unmonitored pregnancy and occipital headache. The general
physical examination showed high blood pressure values, and fetal demise was diagnosed using abdominal ultrasound. During the preparation for Cesarean section the patient developed complicated uterine rupture with urinary bladder lesion resulting in umbilical cord prolapse through the urethra. An emergency laparotomy and supravaginal hysterectomy were performed due to impossibility to repair the uterine wall. The fact that uterine rupture is a life-threatening obstetric emergency and that it is associated with high maternal and perinatal mortality indicates the necessity to consider the risk of rupture and to follow-up on the patient to prevent complications.
References
Murphy DJ. Uterine rupture. Curr Opin Obstet Gynecol. 2006 Apr;18(2):135-40. doi: 10.1097/01.gco.0000192989.45589.57.
Mukasa PK, Kabakyenga J, Senkungu JK et al. Uterine rupture in a teaching hospital in Mbarara, western Uganda, unmatched case- control study. Reprod Health. 2013 May 29; 10:29. doi: 10.1186/1742-4755-10-29.
Wan S, Yang M, Pei J et al. Pregnancy outcomes and associated factors for uterine rupture: an 8years population-based retrospective study. BMC Pregnancy Childbirth. 2022 Feb 1; 22(1):91. doi: 10.1186/s12884-022-04415-6.
Guise JM, McDonagh MS, Osterweil P et al. Systematic review of the incidence and consequences of uterine rupture in women with previous caesarean section. BMJ. 2004 Jul 3;329(7456):19-25. doi: 10.1136/bmj.329.7456.19.
Rodero C, Royo S, Perez D et al. Traumatic rupture of gravid uterus with fetus lying into abdominal cavity: is easy to diagnose? Eur J Obstet Gynecol Reprod Biol. 2004 Dec 1; 117(2):252-3. doi: 10.1016/j.ejogrb.2004.04.007.
Masaoka R, Ohno M, Takamizu et al. A case of unscarred uterine rupture complicated by bladder rupture after vacuum extraction delivery. Hypertension Research in Pregnancy. 2022; 10. 10.14390/jsshp.HRP2022-003.
Ho SY, Chang SD, Liang CC. Simultaneous uterine and urinary bladder rupture in an otherwise successful vaginal birth after cesarean delivery. J Chin Med Assoc. 2010 Dec; 73(12):655-9. doi: 10.1016/S1726-4901(10)70143-X.
Iloabachie GC, Njoku O. Vesico-uterine fistula. Br J Urol. 1985 Aug; 57(4):438-9. doi: 10.1111/j.1464-410x.1985. tb06305.x.
Tanos V, Toney ZA. Uterine scar rupture – Prediction, prevention, diagnosis, and management. Best Pract Res Clin Obstet Gynaecol. 2019 Aug; 59:115-131. doi: 10.1016/j.bpobgyn.2019.01.009.
Habeš D, Střecha M, Kalousek I et al. Uterine rupture during pregnancy. Ceska Gynekol. 2019; 84(5):345-350. English.
Chang YH. Uterine rupture over 11 years: A retrospective descriptive study. Aust N Z J Obstet Gynaecol. 2020 Oct;
(5):709-713. doi: 10.1111/ajo.13133.
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Copyright (c) 2024 N. Stoyanova, `N. Popovski, Y. Popov, T. Totev (Author)
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Journal Acta Medica Bulgarica 
