Department of Human Reproduction, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy.
Minim Invasive Ther Allied Technol. 2022 Mar;31(3):448-455. doi: 10.1080/13645706.2020.1837884. Epub 2020 Dec 17.
In this study, we reviewed the cases of uterine rupture in our setting, identified which of them had previously undergone hysteroscopic septum resection (HSR), and evaluated the main clinical characteristics for each case.
We retrospectively analyzed (ClinicalTrial ID: NCT04449640) the delivery outcomes from the National Perinatal Information System of the National Institute of Public Health of the Republic of Slovenia of the last 20 years (1 January 1999 - 31 December 2019) and cross-linked the patients with surgical data from our electronic database. We collected baseline characteristics, surgical details and obstetrical outcomes. We excluded women who had undergone previous myomectomy or cesarean section (CS) and described the clinical course of each case since no statistical analysis was performed.
We found four patients who had uterine rupture in pregnancy after HSR. Median time to pregnancy was 17 months (range 1-60), all the women underwent CS and fetal-maternal outcomes were acceptable in half of the cases. Symptoms were nonspecific and included pain, fetal distress and vaginal bleeding.
Uterine rupture in pregnancy after a previous HSR is a very rare, but life-threatening event. Prompt diagnosis can ensure successful management and avoid adverse maternal-fetal outcomes.
在本研究中，我们回顾了我们医院的子宫破裂病例，确定了其中哪些患者之前曾接受过宫腔镜下子宫纵隔切除术（HSR），并评估了每个病例的主要临床特征。
我们回顾性分析了（临床试验注册号：NCT04449640）过去 20 年（1999 年 1 月 1 日至 2019 年 12 月 31 日）来自斯洛文尼亚共和国国家公共卫生研究所国家围产期信息系统的分娩结局，并将患者与我们电子数据库中的手术数据进行了交叉链接。我们收集了基线特征、手术细节和产科结局。我们排除了之前接受过子宫肌瘤切除术或剖宫产（CS）的女性，并描述了每位患者的临床病程，因为未进行统计分析。
我们发现 4 例 HSR 后妊娠子宫破裂患者。中位妊娠时间为 17 个月（范围 1-60），所有患者均行 CS，半数患者母婴结局可接受。症状不特异，包括疼痛、胎儿窘迫和阴道出血。
HSR 后妊娠子宫破裂是一种非常罕见但危及生命的事件。及时诊断可以确保成功管理并避免母婴不良结局。
