Groene Hart Hospital, Gouda, the Netherlands.
Leiden University Medical Centre, Leiden, the Netherlands.
Sex Reprod Healthc. 2019 Mar;19:9-14. doi: 10.1016/j.srhc.2018.11.001. Epub 2018 Nov 8.
The present study is a descriptive study of characteristics of women who had a uterine rupture during pregnancy with a history of uterine perforation and no previous caesarean section.
We present a case report of a woman with a uterine rupture in pregnancy subsequent to a perforation made by uterine sounding and we performed a systematic review including all case-reports of uterine ruptures after perforation during dilatation and curettage or due to uterine sounding.
14 case-reports were included in this review. 12 out of 14 women presented with abdominal pain prior to the uterine rupture. In eight out of 14 cases an abdominal ultrasound was performed and in five ultrasounds a uterine wall defect was detected, in two other cases free fluid was visible and in one case fetal bradycardia was seen. Neonatal outcome was uneventful in six cases, there where two immature fetuses born and in two cases there was fetal demise.
Uterine rupture in a (supposed) unscarred uterus is a relatively unknown complication. We recommend clinicians to be aware of uterine rupture in pregnant women with abdominal pain and a history of uterine manipulation. When a uterine rupture is suspected and mother and fetus are in suspected good condition, an ultrasound examination could be an easy and fast next step.
本研究是对有子宫穿孔史且无剖宫产史的孕妇发生子宫破裂的特征进行的描述性研究。
我们报告了一例因子宫探查穿孔导致妊娠子宫破裂的病例，并进行了系统回顾，包括所有因刮宫或子宫探查穿孔导致的子宫破裂的病例报告。
本综述共纳入 14 例病例报告。14 例女性中有 12 例在子宫破裂前出现腹痛。14 例中有 8 例行腹部超声检查，其中 5 例超声检查发现子宫壁缺陷，另外 2 例可见游离液体，1 例可见胎儿心动过缓。6 例新生儿结局良好，有 2 例早产儿出生，有 2 例胎儿死亡。
（假定）未瘢痕化子宫的子宫破裂是一种相对未知的并发症。我们建议临床医生注意有腹痛和子宫操作史的孕妇发生子宫破裂的情况。当怀疑发生子宫破裂且母婴情况疑似良好时，超声检查可能是一种简单、快速的下一步检查方法。
