Uterine rupture in pregnancy subsequent to hysteroscopic surgery: A case series

Abstract

Uterine rupture during pregnancy is associated with high mortality and morbidity rates in both the fetus and the mother. Hysteroscopic surgeries such as myomectomy and septum resection are known risk factors for uterine rupture in pregnancy following the operation. We present four infertile patients who were admitted to Kocaeli Medical Park Hospital between February 2014 and November 2016. Three of the patients underwent hysteroscopic septum resection without complication and one had hysteroscopic myomectomy and a 7-8 mm sized rupture was detected. All of the patients became pregnant in less than a year after the operations. The first three patients had uterine rupture at 22^nd, 38^th, and 10^th week, which is the earliest rupture in the literature. The last patient had an uneventful pregnancy and the rupture was observed during cesarean section. A short interval between hysteroscopy and pregnancy may increase the risk of rupture. It may be possible to become pregnant despite rupture and not have any problems during the entire pregnancy.

Keywords: Hysteroscopy; pregnancy; uterine rupture.

Figure 1. Perforation of the uterus during hysteroscopic myomectomy

Figure 2. Full thickness, unhealed or scar dehiscence of previous perforation area noticed during elective cesarean section after the baby is delivered

Figure 3. Uterine repair of the defect with two layer sutures