Ilunga-Mbaya Eloge, Nyakio Olivier, Maroyi Raha, Bigabwa Patrick, Kiminyi Moise, Hamisi Silas, Mukwege Dénis, Amani Dieudonné Sengeyi Mushengezi
Département de Gynécologie et Obstétrique, Cliniques Universitaires de Kinshasa, Faculté de Médecine de l'Université de Kinshasa, Kinshasa, République Démocratique du Congo.
Département de Gynécologie et Obstétrique, Hôpital Général de Référence de Panzi, Faculté de Médecine de l'Université Evangélique d'Afrique, Bukavu, République Démocratique du Congo.
Pan Afr Med J. 2020 May 28;36:44. doi: 10.11604/pamj.2020.36.44.20692. eCollection 2020.
Despite all the health policies implemented in our developing countries, uterine rupture (RU) remains common. They are severe and involve maternal and fetal prognosis. Among the multiple risk factors, the most common cited in the literature is C-section scar. Most occurs during labor or at the end of pregnancy. Uterine rupture during the first or second trimester is exceptional and its clinical manifestation is variable. We here report a case of spontaneous uterine rupture at 15 weeks' gestation in a pauciparous woman with scarred uterus. Exacerbation of clinical symptoms was manifested by peritoneal irritation. Surgical exploration revealed complete vertical rupture from the bottom to the lower segment of the uterus with open book opening of the uterus. This study highlights that uterine rupture should be considered in patients with scarred uterus presenting with abdominal pain associated with signs of hemoperitoneum, regardless of whether their pregnancies are at term or in the first two trimesters, and regardless of age (young patients) and parity.
尽管我们发展中国家实施了所有的卫生政策,但子宫破裂(RU)仍然很常见。它很严重,涉及母婴预后。在多种风险因素中,文献中最常提到的是剖宫产瘢痕。大多数子宫破裂发生在分娩期间或妊娠末期。妊娠早期或中期发生子宫破裂的情况很罕见,其临床表现也各不相同。我们在此报告一例妊娠15周时子宫瘢痕化经产妇发生自发性子宫破裂的病例。临床症状加重表现为腹膜刺激征。手术探查发现子宫从底部到下段完全垂直破裂,子宫呈书本样打开。本研究强调,对于有子宫瘢痕且出现腹痛伴有腹腔内出血体征的患者,无论其妊娠处于足月还是妊娠前两个月,也无论年龄(年轻患者)和产次如何,都应考虑子宫破裂的可能。