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: firstname.lastname@example.org.
Received January 24, 2002. Received in revised form April 10, 2002. Accepted April 11, 2002.