Spontaneous uterine rupture during delivery in a patient who had previously undergone laparoscopic myomectomy

Introduction Following laparoscopic myomectomy, uterine rupture during pregnancy or delivery in the area of the scar is a very rare but dangerous complication. Individual cases of uterine rupture during pregnancy are described in the literature. Setting University Teaching Hospital. Material Casereport of uterine rupture after delivery in a patient who had previously undergone laparoscopic myomectomy. In the case presented here, the patient conceived 2 months after an 8-cm subserous myoma with a pedicle had been laparoscopically removed. Intervention No symptoms suggesting uterine rupture were observed during the pregnancy. Spontaneous vaginal delivery was under way, but in the third stage of delivery the condition of the patient deteriorated and symptoms of oligaemic shock developed. A laparotomy was performed, which showed the presence of blood in the peritoneal cavity and ruptured uterine muscle in the scarred area about 5 cm. Conclusions In patients who have previously undergone a laparoscopic myomectomy, there is some risk of uterine muscle rupture at delivery. This is also the case where no suturing of the uterine muscle had been required.