Andrea Tinelli1,2,3,4, Ioannis P Kosmas3,5, Jose Tony Carugno6, Howard Carp7, Antonio Malvasi3,8, Shlomo B Cohen7, Antonio Simone Laganà9, Marta Angelini10, Paolo Casadio11, Jenifer Chayo7, Ettore Cicinelli12, Sandro Gerli13, Josè Palacios Jaraquemada14, Giulia Magnarelli11, Mykhailo V Medvediev15, Josè Metello16, Luigi Nappi17, Jude Okohue18, Radmila Sparic19, Radomir Stefanović19, Avinoam Tzabari20, Antonella Vimercati12. 1. Department of Obstetrics and Gynecology and CERICSAL (CEntro di RIcerca Clinico SALentino), "Veris delli Ponti Hospital", Scorrano, Lecce, Italy. 2. Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy, Vito Fazzi Hospital, Lecce, Italy. 3. Laboratory of Human Physiology, Phystech BioMed School, Faculty of Biological & Medical Physics, Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia. 4. Department of Obstetrics and Gynecology, Veris delli Ponti Hospital, Scorrano & Vito Fazzi Hospital, Lecce, Italy. 5. Department of Obstetrics and Gynecology, Ioannina State General Hospital G. Hatzikosta, University of Ioannina, Ioannina, Greece. 6. MIGS/Robotics Division Director, University of Miami, Miller School of Medicine, Miami, FL, USA. 7. Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel. 8. Department of Obstetrics and Gynecology, Santa Maria Hospital, GVM Care & Research, Bari, Italy. 9. Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy. 10. Department of Obstetrics and Gynecology, Medical School, University of Udine, Udine, Italy. 11. Department of Obstetrics and Gynecology, Medical School, University of Bologna, Bologna, Italy. 12. Department of Obstetrics and Gynecology, Medical School, University of Bari, Bari, Italy. 13. Department of Obstetrics and Gynecology, Medical School, University of Perugia, Perugia, Italy. 14. Department of Obstetrics and Gynecology, Medical School, University of Buenos Aires, Buenos Aires, Argentina. 15. Department of Obstetrics and Gynecology, University of Dnepropetrovsk medical academy of Health Ministry of Ukraine, Dnepropetrovsk, Ukraine. 16. Centro de Infertilidade e Reprodução Medicamente Assistida, Hospital Garcia de Orta, Almada, Portugal. 17. Department of Obstetrics and Gynecology, Medical School, University of Foggia, Foggia, Italy. 18. Department of Obstetrics and Gynecology, Madonna University Teaching Hospital, Port Harcourt, Nigeria. 19. Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, Serbia. 20. Department of Obstetrics and Gynecology, Hospital Mayane Hayeshua Medical Center, Bnei Brak, Israel.
Abstract
OBJECTIVE: To describe the characteristics and peripartum outcomes of patients diagnosed with uterine rupture (UR) by an observational cohort retrospective study on 270 patients. METHODS: Demographic information, surgical history, symptoms, and postoperative outcome of women and neonates after UR were collected in a large database. The statistical analysis searched for correlation between UR, previous uterine interventions, fibroids, and the successive perinatal outcomes in women with previous UR. RESULTS: Uterine rupture was significantly associated with previous uterine surgery, occurring, on average, at 36 weeks of pregnancy in women also without previous uterine surgery. UR did not rise exponentially with an increasing number of uterine operations. Fibroids were related to UR. The earliest UR occurred at 159 days after hysteroscopic myomectomy, followed by laparoscopic myomectomy (251 days) and laparotomic myomectomy (253 days). Fertility preservation was feasible in several women. Gestational age and birth weight seemed not to be affected in the subsequent pregnancy. CONCLUSION: Data analysis showed that previous laparoscopic and abdominal myomectomies were associated with UR in pregnancy, and hysteroscopic myomectomy was associated at earlier gestational ages. UR did not increase exponentially with an increasing number of previous scars. UR should not be considered a contraindication to future pregnancies.
OBJECTIVE: To describe the characteristics and peripartum outcomes of patients diagnosed with uterine rupture (UR) by an observational cohort retrospective study on 270 patients. METHODS: Demographic information, surgical history, symptoms, and postoperative outcome of women and neonates after UR were collected in a large database. The statistical analysis searched for correlation between UR, previous uterine interventions, fibroids, and the successive perinatal outcomes in women with previous UR. RESULTS: Uterine rupture was significantly associated with previous uterine surgery, occurring, on average, at 36 weeks of pregnancy in women also without previous uterine surgery. UR did not rise exponentially with an increasing number of uterine operations. Fibroids were related to UR. The earliest UR occurred at 159 days after hysteroscopic myomectomy, followed by laparoscopic myomectomy (251 days) and laparotomic myomectomy (253 days). Fertility preservation was feasible in several women. Gestational age and birth weight seemed not to be affected in the subsequent pregnancy. CONCLUSION: Data analysis showed that previous laparoscopic and abdominal myomectomies were associated with UR in pregnancy, and hysteroscopic myomectomy was associated at earlier gestational ages. UR did not increase exponentially with an increasing number of previous scars. UR should not be considered a contraindication to future pregnancies.
Authors: Ahmed Issak Hussein; Abdikarim Ali Omar; Hodan Abdi Hassan; Mohamed Mukhtar Kassim; Abdisalam Abdullahi Yusuf; Ahmed Adam Osman Journal: Int Med Case Rep J Date: 2022-10-06