Background: Uterine septa may be responsible for spontaneous abortion. Hysteroscopic metroplasty may improve pregnancy outcome.
Case: A patient with a history of hysteroscopic resection of a uterine septum presented in preterm labor. This was her second pregnancy following the procedure; the first resulted in a term vaginal delivery. This second pregnancy ended with a preterm cesarean delivery. A 3.5 × 3.5-cm fundal rupture was discovered during the cesarean. The metroplasty had been performed with the KTP laser under direct laparoscopic visualization. No surgical complications had occurred.
Conclusion: Uterine rupture during a pregnancy may occur following hysteroscopic metroplasty, even when no complications occur at surgery and even if a normal pregnancy outcome follows the procedure. Physicians providing care for patients who have had hysteroscopic metroplasty should be aware of the potential for uterine rupture during pregnancy.(Obstet Gynecol 1994;83:838-40)
© 1994 The American College of Obstetricians and Gynecologists