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Uterine Rupture at Term After Uncomplicated Hysteroscopic Metroplasty

Angell, Norman F. MD, PhD; Domingo, Josefina Tan MD; Siddiqi, Naeem MD

Case Reports

BACKGROUND In patients with a prior uterine septum resection, uterine rupture during pregnancy has been reported with the use of energy sources or when complicated by perforation.

CASE A woman was found to have a uterine abnormality during her first pregnancy. After delivery, a septum was diagnosed and hysteroscopically incised using cold scissors without complication. Follow-up hysterosalpingogram showed a small residual septum. In her subsequent pregnancy, emergency cesarean after fetal bradycardia in early labor showed the placenta and fetus totally exteriorized through a cornua to cornua rupture of the fundus.

CONCLUSION Uterine rupture during pregnancy after metroplasty is rare but may occur regardless of the method of metroplasty, absence of complications, or careful follow-up.

Rupture of the uterus in early labor at term occurred in a woman with a prior uneventful hysteroscopic metroplasty.

Slocum-Dickson Medical Group, PC, Utica; and Lewis County General Hospital, Lowville, New York

Address reprint requests to: Norman F. Angell, MD, PhD, Department of OB/GYN, University of South Alabama, 251 Cox Street, Suite 100, Mobile, AL 36604; E-mail: nangell@jaguar1.usouthal.edu.

Received January 24, 2002. Received in revised form April 10, 2002. Accepted April 11, 2002.

© 2002 The American College of Obstetricians and Gynecologists