UTERINE RUPTURE FOLLOWING LAPAROSCOPIC SALPINGECTOMY- A RARE CASE SCENARIO

Abstract

INTRODUCTION: Uterine rupture is an obstetric emergency accounting for 3% of total maternal deaths. Most common
cause is giving way of a previous cesarean or hysterotomy scar. The incidence of rupture uterus following laparoscopic
surgeries is extremely low.
CASE DETAILS: A 25year old, gravida 2, para 0, at 24+2 weeks of gestation, was brought to the emergency department
with abdominal pain of sudden onset. She conceived 2months after laparoscopic salpingectomy, which was done in v/o
cornual ectopic pregnancy. Ultrasound revealed uterine rupture and an emergency laparotomy was done. The entire
amniotic sac was found in the peritoneal cavity with a rupture of the lateral wall of the uterus. Fetus delivered out, and
uterus repaired in layers. Postoperative recovery was uneventful.
DISCUSSION: Complete uterine rupture is defined as a nonsurgical disruption of all the layers of uterus. A case report of
Nishijima Y et al. on Uterine rupture at 26 weeks of pregnancy following laparoscopic salpingectomy emphasizes the
importance of regular follow up of pregnant patients with prior uterine surgery.
CONCLUSION: Surgeons should ensure strict training of laparoscopic suture skills, limit the use of energy equipment,
and ensure effective hemostasis by suturing and close the uterine defect with enough layers. Long term follow up of
patients treated for cornual pregnancy with endometrial involvement is necessary.