4y,g3p0+2, 37 w,iufd,induction of labor with cytotec.
delivery occurred after 12 hrs .
lab ix were normal.
uterine exploration revealed rupture uterus .
laparotomy reveled....rupture extended from fundus down to the cervix and vagina on left side with avulsion of infundibulo-pelvic ligament and ovary was attached to the uterus by ovarian ligament .
repair of the tear was done with good hemostasis.
there was no hematoma retroperitoneal nor ligament ,ovarian artery or plexus of veins were identified .
drains inserted and patient recovered.
the question is :
where the ovarian should be searched for ?
why there were no bleeding from the injured vessels?
has this been encountered before and reported in literature ?
what about thrombosis of ovarian vessels and followup?
4y,g3p0+2, 37 w,iufd,induction of labor with cytotec.
delivery occurred after 12 hrs .
lab ix were normal.
uterine exploration revealed rupture uterus .
laparotomy reveled....rupture extended from fundus down to the cervix and vagina on left side with avulsion of infundibulo-pelvic ligament and ovary was attached to the uterus by ovarian ligament .
repair of the tear was done with good hemostasis.
there was no hematoma retroperitoneal nor ligament ,ovarian artery or plexus of veins were identified .
drains inserted and patient recovered.
the question is :
where the ovarian should be searched for ?
why there were no bleeding from the injured vessels?
has this been encountered before and reported in literature ?
what about thrombosis of ovarian vessels and followup?
Are these papers of interest for you?
Article Posterior Uterine Rupture Causing Fetal Expulsion into the A...
Article A Case Series of Uterine Rupture: Lessons to be Learned for ...
Article Uterine Rupture: A Seven Year Review at a Tertiary Care Hosp...
Thanks so much for the reply.
kindly ,update with management of avulsion and retraction of ovarian vessels with rupture and no trace nor bleeding after .
I am sorry, I do not find anything with no trace of bleeding (she had to be in serious shock) but contact the authors e.g. Harry Reich
here on RG and they will provide more and better information. Good luck!
Article New techniques in advanced laparoscopic surgery
Silent rapture with no bleeding frequently seen with previous scar and I saw two cases with no complications; and usually the cause was because of patient delay in attending hospital. For your patient if she is 37 years old and nilipara how she go into this force labor. Did she under good observation, from my experience there should be feral and uterine sign prior to rapture. Where is the doctor? I faced rapture uterus before but all came with history of home midwife interference. Our rule is to minimise this tragedy as much as possible
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