Prepregnancy Hysteroscopic Image in a Patient in whom Spontaneous Uterine Rupture Occurred in the 27th Week of Pregnancy after Adenomyomectomy

Takashi Matsushima; Mutsumi Kuroki

doi:10.4103/gmit.gmit_136_22

Prepregnancy Hysteroscopic Image in a Patient in whom Spontaneous Uterine Rupture Occurred in the 27^th Week of Pregnancy after Adenomyomectomy

Gynecol Minim Invasive Ther. 2023 Aug 10;12(3):189-190. doi: 10.4103/gmit.gmit_136_22. eCollection 2023 Jul-Sep.

Authors

Takashi Matsushima¹, Mutsumi Kuroki¹

Affiliation

¹ Department of Obstetrics and Gynecology, Nippon Medical School Musashi Kosugi Hospital, Kawasaki, Kanagawa, Japan.

Abstract

We describe a preconception hysteroscopic image of a patient with a ruptured uterus at 27 weeks' gestation. A 40-year-old gravida 2, para 1, underwent open adenomyomectomy because of infertility. Subsequently, hysteroscopy performed at our hospital revealed an endometrial deficit from the uterine fundus to the posterior wall, and an area where the endometrium was missing and composed of yellow tissue was seen. She later achieved pregnancy. Lower abdominal pain occurred on day 1 of the 27^th week of pregnancy. She suddenly went into a state of shock. Emergency laparotomy was performed, and a uterine rupture wound of approximately 10 cm in the longitudinal direction was seen in the posterior wall. A 1120-g male infant was stillborn. Total blood loss was 6450 mL. The mother was saved without hysterectomy. After adenomyomectomy, a hysteroscopy should be performed to check for endometrial defects before allowing pregnancy.

Keywords: Adenomyomectomy; hysteroscopy; pregnancy; uterine rupture.

Publication types

Case Reports