Is it possible to early diagnose uterine rupture by ultrasound without common clinical signs during pregnancy following laparoscopic myomectomy?

Abstract

Although spontaneous uterine rupture following laparoscopic myomectomy is rare, it can lead to life-threatening complications for both mother and fetus. The authors report a case of a nulliparous woman at gestation of 30 weeks and four days who was referred from local clinic because of diffused abdominal pain. She conceived spontaneously 1.8 years after myomectomy. The fetal heart pattern was reassuring, there were no regular uterine contractions or vaginal bleeding, and her vital signs were stable. A critical clue to diagnosis of uterine rupture was an abrupt defect of uterine wall without fluid or fetal part in pelvic cavity on ultrasound. An emergency cesarean section was performed, uterine rupture was found, and the neonate was delivered in good condition. For timely surgical intervention to yield a favorable outcome, evaluation of myometrium continuity by ultrasound is valuable in pregnancy following laparoscopic myomectomy in the absence of typical clinical signs.