1
|
Chen R, Zhou W, Wang Z, Cheng Z. A Rare Secondary Dysmenorrhea Resulted from Separation of Corpus Uteri from Cervix: A Case Report and Literature Review. J Minim Invasive Gynecol 2023; 30:240-244. [PMID: 36402379 DOI: 10.1016/j.jmig.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/04/2022] [Accepted: 11/09/2022] [Indexed: 11/18/2022]
Abstract
Secondary dysmenorrhea is a pain associated with disease such as endometriosis, pelvic inflammatory disease, leiomyomas, and interstitial cystitis. Treatment of secondary dysmenorrhea always focuses on the causative pelvic pathology or medical condition. Here, we found a rare case with secondary dysmenorrhea that resulted from traumatic separation of the uterine corpus from the cervix. In this case, the patient experienced a childhood blunt trauma of the pelvic crush and was successfully diagnosed by magnetic resonance imaging and 3-dimensional ultrasonography. Moreover, laparoscopic anastomosis could be a minimally invasive way to resolve this problem.
Collapse
Affiliation(s)
- Rong Chen
- Department of Gynecology and Obstetrics, Shanghai Tenth People's Hospital (Drs. Chen, Zhou, Wang, and Cheng); Tongji University School of Medicine (Drs. Chen, Zhou, Wang, and Cheng); Institute of Gynecologic Minimal Invasive Medicine, Tongji University (Drs. Chen, Zhou, and Cheng), Shanghai, P.R. China
| | - Wenni Zhou
- Department of Gynecology and Obstetrics, Shanghai Tenth People's Hospital (Drs. Chen, Zhou, Wang, and Cheng); Tongji University School of Medicine (Drs. Chen, Zhou, Wang, and Cheng); Institute of Gynecologic Minimal Invasive Medicine, Tongji University (Drs. Chen, Zhou, and Cheng), Shanghai, P.R. China
| | - Zhongjie Wang
- Department of Gynecology and Obstetrics, Shanghai Tenth People's Hospital (Drs. Chen, Zhou, Wang, and Cheng); Tongji University School of Medicine (Drs. Chen, Zhou, Wang, and Cheng)
| | - Zhongping Cheng
- Department of Gynecology and Obstetrics, Shanghai Tenth People's Hospital (Drs. Chen, Zhou, Wang, and Cheng); Tongji University School of Medicine (Drs. Chen, Zhou, Wang, and Cheng); Institute of Gynecologic Minimal Invasive Medicine, Tongji University (Drs. Chen, Zhou, and Cheng), Shanghai, P.R. China.
| |
Collapse
|
2
|
Chiossi G, D’Amico R, Tramontano AL, Sampogna V, Laghi V, Facchinetti F. Prevalence of uterine rupture among women with one prior low transverse cesarean and women with unscarred uterus undergoing labor induction with PGE2: A systematic review and meta-analysis. PLoS One 2021; 16:e0253957. [PMID: 34228760 PMCID: PMC8259955 DOI: 10.1371/journal.pone.0253957] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/16/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND As uterine rupture may affect as many as 11/1000 women with 1 prior cesarean birth and 5/10.000 women with unscarred uterus undergoing labor induction, we intended to estimate the prevalence of such rare outcome when PGE2 is used for cervical ripening and labor induction. METHODS We searched MEDLINE, ClinicalTrials.gov and the Cochrane library up to September 1st 2020. Retrospective and prospective cohort studies, as well as randomized controlled trials (RCTs) on singleton viable pregnancies receiving PGE2 for cervical ripening and labor induction were reviewed. Prevalence of uterine rupture was meta-analyzed with Freeman-Tukey double arcsine transformation among women with 1 prior low transverse cesarean section and women with unscarred uterus. RESULTS We reviewed 956 full text articles to include 69 studies. The pooled prevalence rate of uterine rupture is estimated to range between 2 and 9 out of 1000 women with 1 prior low transverse cesarean (5/1000; 95%CI 2-9/1000, 122/9000). The prevalence of uterine rupture among women with unscarred uterus is extremely low, reaching at most 0.7/100.000 (<1/100.000.000; 95%CI <1/100.000.000-0.7/100.000, 8/17.684). CONCLUSIONS Uterine rupture is a rare event during cervical ripening and labor induction with PGE2.
Collapse
Affiliation(s)
- Giuseppe Chiossi
- Division of Obstetrics, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy
| | - Roberto D’Amico
- Statistics Unit, Department of Diagnostic and Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | - Anna L. Tramontano
- Division of Obstetrics, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy
| | - Veronica Sampogna
- Division of Obstetrics, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy
| | - Viola Laghi
- Division of Obstetrics, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy
| | - Fabio Facchinetti
- Division of Obstetrics, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy
| |
Collapse
|
3
|
Ma H, Qiao Z. Analysis of the efficacy of resveratrol treatment in patients with scarred uterus. Exp Ther Med 2018; 15:5410-5414. [PMID: 29904420 DOI: 10.3892/etm.2018.6126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 09/01/2017] [Indexed: 01/13/2023] Open
Abstract
Scarred uterus is caused by cesarean section surgery, and this condition affects further gestation and delivery in patients. Previous evidence suggested that resveratrol, a polyphenol compound, presents beneficial outcomes for patients with scarred uterus. Therefore, the aim of the present study was to analyze the efficacy of resveratrol in the treatment of patients with scarred uterus. The efficacy of resveratrol in the formation of new vessels and re-epithelialization of the endometrium was analyzed. The present results demonstrated that resveratrol treatment reduced uterus scarring in the majority of patients (87.36%) compared with the control. It was also observed that the plasma levels of β-human chorionic gonadotropin were downregulated by resveratrol treatment in patients with scarred uterus. Furthermore, resveratrol treatment promoted the remodeling of the scarred uterus, the regeneration of the endometrium and improved pregnancy outcomes. In conclusion, the findings of the current study indicate that resveratrol treatment may be a potential strategy for the treatment of scarred uterus patients, which contributes to the improvement of pregnancy outcomes.
Collapse
Affiliation(s)
- Huashu Ma
- Department of Gynecology, Xingtai People's Hospital, Hebei Medical University Affiliated Hospital Obstetric, Xingtai, Hebei 054001, P.R. China
| | - Zongxu Qiao
- Department of Gynecology, Xingtai People's Hospital, Hebei Medical University Affiliated Hospital Obstetric, Xingtai, Hebei 054001, P.R. China
| |
Collapse
|
4
|
Sturzenegger K, Schäffer L, Zimmermann R, Haslinger C. Risk factors of uterine rupture with a special interest to uterine fundal pressure. J Perinat Med 2017; 45:309-313. [PMID: 27235667 DOI: 10.1515/jpm-2016-0023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 04/19/2016] [Indexed: 11/15/2022]
Abstract
PURPOSE Uterine rupture is a rare but serious event with a median incidence of 0.09%. Previous uterine surgery is the most common risk factor. The aim of our study was to analyze retrospectively women with uterine rupture during labor and to evaluate postulated risk factors such as uterine fundal pressure (UFP). METHODS Twenty thousand one hundred and fifty-two deliveries were analyzed retrospectively. Inclusion criteria were 22 weeks and 0 days-42 weeks and 0 days of gestation, singleton pregnancy and cephalic presentation. Women with primary cesarean section were excluded. A logistic regression analysis adjusting for possible risk factors was conducted and a subgroup analysis of women with unscarred uterus was performed. RESULTS Twenty-eight cases of uterine rupture were identified (incidence: 0.14%). Uterine rupture was noticed in multipara patients only. In the multivariate analysis among all study patients, only previous cesarean section remained a statistically significant risk factor [adjusted odds ration (adj. OR) 12.52 confidence interval (CI) 95% 5.21-30.09]. In the subgroup analysis among women with unscarred uterus (n=19,415) three risk factors were associated with uterine rupture: UFP (adj. OR 5.22 CI 95% 1.07-25.55), abnormal placentation (adj. OR 20.82 CI 95% 2.48-175.16) and age at delivery >40 years (adj. OR 4.77 CI 95% 1.44-15.85). CONCLUSIONS The main risk factor for uterine rupture in the whole study population is previous uterine surgery. Risk factors in women with unscarred uterus were UFP, abnormal placentation, and age at delivery >40 years. The only factor which can be modified is UFP. We suggest that UFP should be used with caution at least in presence of other supposed risk factors.
Collapse
Affiliation(s)
- Karin Sturzenegger
- Division of Obstetrics, University Hospital of Zürich, Frauenklinikstrasse 10, 8091 Zürich
| | - Leonhard Schäffer
- Division of Obstetrics, University Hospital of Zürich, Frauenklinikstrasse 10, 8091 Zürich
| | - Roland Zimmermann
- Division of Obstetrics, University Hospital of Zürich, Frauenklinikstrasse 10, 8091 Zürich
| | - Christian Haslinger
- Division of Obstetrics, University Hospital of Zürich, Frauenklinikstrasse 10, 8091 Zürich
| |
Collapse
|
5
|
Guiliano M, Closset E, Therby D, LeGoueff F, Deruelle P, Subtil D. Signs, symptoms and complications of complete and partial uterine ruptures during pregnancy and delivery. Eur J Obstet Gynecol Reprod Biol 2014; 179:130-4. [PMID: 24965993 DOI: 10.1016/j.ejogrb.2014.05.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 05/07/2014] [Accepted: 05/12/2014] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Uterine rupture is a rare but potentially catastrophic complication of pregnancy that requires rapid diagnosis. Classically, its signs and symptoms combine pain, fetal heart rate (FHR) abnormalities, and vaginal bleeding. The purpose of this study is to identify these signs and symptoms as well as the immediate complications of complete and incomplete (partial) ruptures of the uterine wall, whether or not they follow a previous cesarean delivery. STUDY DESIGN Retrospective study of case records from two university hospital maternity units, from 1987 to 2008. RESULTS In a total of 97,028 births during the study period, we identified 52 uterine ruptures (0.05%): 25 complete and 27 partial. Most (89%) occurred in women with a previous cesarean delivery. In complete ruptures, FHR abnormalities were the most frequent sign (82%), while the complete triad of FHR abnormalities-pain-vaginal bleeding was present in only 9%. The signs and symptoms of partial ruptures were very different; these were asymptomatic in half the cases (48%). Neonatal mortality reached 13.6% among the complete ruptures; 27 and 40% of these newborns had pH<6.80 and pH<7.0, respectively. Among the incomplete ruptures, only 7.7% of the newborns had a pH<7.0 and there were no deaths. CONCLUSION Although complete rupture of the uterus has a severe neonatal prognosis, the complete set of standard symptoms is present in less than 10% of cases. FHR abnormalities are by far the most frequent sign.
Collapse
Affiliation(s)
- M Guiliano
- Pôle Femme Mère Nouveau-né et Pôle d'Anesthésie-Réanimation, Hôpital Jeanne de Flandre, Université Lille Nord de France, 1 rue Eugène Avinée, Lille Cedex 59037, France.
| | - E Closset
- Pôle Femme Mère Nouveau-né et Pôle d'Anesthésie-Réanimation, Hôpital Jeanne de Flandre, Université Lille Nord de France, 1 rue Eugène Avinée, Lille Cedex 59037, France
| | - D Therby
- Pavillon Paul Gellé, Centre Hospitalier de Roubaix, 91 avenue J Lagache, Roubaix 59100, France
| | - F LeGoueff
- Pavillon Paul Gellé, Centre Hospitalier de Roubaix, 91 avenue J Lagache, Roubaix 59100, France
| | - P Deruelle
- Pôle Femme Mère Nouveau-né et Pôle d'Anesthésie-Réanimation, Hôpital Jeanne de Flandre, Université Lille Nord de France, 1 rue Eugène Avinée, Lille Cedex 59037, France; EA 4489, Faculté de Médecine Henri Warembourg, Université Lille 2, UPRES Lille Nord de France, Lille, France
| | - D Subtil
- Pôle Femme Mère Nouveau-né et Pôle d'Anesthésie-Réanimation, Hôpital Jeanne de Flandre, Université Lille Nord de France, 1 rue Eugène Avinée, Lille Cedex 59037, France; EA2694, UDSL, Université Lille Nord de France, UHC Lille, Lille F-59000, France
| |
Collapse
|
6
|
Manisha, Meena J, Singh A, Singh A. A Rare Case of Vaginal Delivery After Uterine Rupture. J Obstet Gynaecol India 2012; 62:566-7. [DOI: 10.1007/s13224-012-0124-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2008] [Accepted: 10/10/2010] [Indexed: 11/30/2022] Open
|
7
|
Ceci O, Cantatore C, Scioscia M, Nardelli C, Ravi M, Vimercati A, Bettocchi S. Ultrasonographic and hysteroscopic outcomes of uterine scar healing after cesarean section: Comparison of two types of single-layer suture. J Obstet Gynaecol Res 2012; 38:1302-7. [DOI: 10.1111/j.1447-0756.2012.01872.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
8
|
Waseem M, Cunningham-Deshong H, Gernsheimer J. Abdominal Pain in a Postpartum Patient. J Emerg Med 2011; 41:261-4. [DOI: 10.1016/j.jemermed.2010.05.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2009] [Revised: 02/18/2010] [Accepted: 05/14/2010] [Indexed: 11/25/2022]
|
9
|
Gómez LR, Burgos J, Cobos P, Melchor JC, Osuna C, Centeno MDM, Larrieta R, Fernández-Llebrez L, Martínez-Astorquiza T. Oxytocin versus dinoprostone vaginal insert for induction of labor after previous cesarean section: a retrospective comparative study. J Perinat Med 2011; 39:397-402. [PMID: 21604996 DOI: 10.1515/jpm.2011.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare the efficacy and safety of two methods for induction of labor after previous cesarean section. METHODS To compare 247 women with a previous cesarean section who were induced with a dinoprostone vaginal insert and 279 women with a previous cesarean section induced with oxytocin, between 2001 and 2008. We evaluated vaginal delivery rate, maternal morbidity and newborn morbidity and mortality. RESULTS The overall rate of vaginal delivery was 65.2%. We did not find significant differences between induction with dinoprostone vaginal insert and oxytocin in the rate of cesarean section performed (35.6% vs. 34.1%, P=0.71). There were nine cases of uterine rupture (rate of 1.7%), of which four occurred with dinoprostone vaginal insert and five when using oxytocin (P=0.89). We found no significant differences in neonatal outcomes. CONCLUSIONS Both tested methods appear to be equally safe and effective for induction of labor in women with a previous cesarean section.
Collapse
|
10
|
|
11
|
Gregory KD, Fridman M, Korst L. Trends and patterns of vaginal birth after cesarean availability in the United States. Semin Perinatol 2010; 34:237-43. [PMID: 20654773 DOI: 10.1053/j.semperi.2010.03.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A review of the literature and analysis of the National Inpatient Sample Database was performed to describe the trends in vaginal birth after cesarean availability in the United States and the factors associated with changing use. Vaginal birth after cesarean increased after the first National Institutes of Health Consensus Conference on Cesarean Childbirth in 1981. It increased from 3% to a maximum rate of 28.3% in 1996. Despite studies reporting stable success rates of approximately 70% and low complication rates (<1%), concerns about patient safety and physician liability have led to more restrictive policies and a decrease in vaginal birth after cesarean use. The current rate is approximately 8.5%, and decreased rates have been noted for all age and ethnic groups. There is decreased use of vaginal birth after cesarean as the result of concerns about patient safety and physician liability, which has resulted in decreased availability.
Collapse
Affiliation(s)
- Kimberly D Gregory
- Department Obstetrics & Gynecology, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA.
| | | | | |
Collapse
|
12
|
Al-Zirqi I, Stray-Pedersen B, Forsén L, Vangen S. Uterine rupture after previous caesarean section. BJOG 2010; 117:809-20. [DOI: 10.1111/j.1471-0528.2010.02533.x] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
13
|
Zwart JJ, Richters JM, Ory F, de Vries JIP, Bloemenkamp KWM, van Roosmalen J. Uterine rupture in The Netherlands: a nationwide population-based cohort study. BJOG 2009; 116:1069-78; discussion 1078-80. [PMID: 19515148 DOI: 10.1111/j.1471-0528.2009.02136.x] [Citation(s) in RCA: 171] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess incidence of uterine rupture in scarred and unscarred uteri and its maternal and fetal complications in a nationwide design. DESIGN Population-based cohort study. SETTING All 98 maternity units in The Netherlands. POPULATION All women delivering in The Netherlands between August 2004 and August 2006 (n = 371,021). METHODS Women with uterine rupture were prospectively collected using a web-based notification system. Data from all pregnant women in The Netherlands during the study period were obtained from Dutch population-based registers. Results were stratified by uterine scar. MAIN OUTCOME MEASURES Population-based incidences, severe maternal and neonatal morbidity and mortality, relative and absolute risk estimates. RESULTS There were 210 cases of uterine rupture (5.9 per 10,000 pregnancies). Of these women, 183 (87.1%) had a uterine scar, incidences being 5.1 and 0.8 per 10,000 in women with and without uterine scar. No maternal deaths and 18 cases of perinatal death (8.7%) occurred. The overall absolute risk of uterine rupture was 1 in 1709. In univariate analysis, women with a prior caesarean, epidural anaesthesia, induction of labour (irrespective of agents used), pre- or post-term pregnancy, overweight, non-Western ethnic background and advanced age had an elevated risk of uterine rupture. The overall relative risk of induction of labour was 3.6 (95% confidence interval 2.7-4.8). CONCLUSION The population-based incidence of uterine rupture in The Netherlands is comparable with other Western countries. Although much attention is paid to scar rupture associated with uterotonic agents, 13% of ruptures occurred in unscarred uteri and 72% occurred during spontaneous labour.
Collapse
Affiliation(s)
- J J Zwart
- Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands.
| | | | | | | | | | | |
Collapse
|