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An Unusual Case of Spontaneous Uterine Rupture After a Salpingectomy Following an Interstitial Ectopic Pregnancy

Received: 11 August 2021    Accepted: 26 August 2021    Published: 31 August 2021
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Abstract

Spontaneous uterine rupture following a history of surgical treatment of an interstitial tubal ectopic pregnancy (EP) is a rare clinical form. This uterine rupture occurring after a wedge resection of the uterine horn, is a serious obstetric complication involving maternal and fetal vital prognosis and obstetric fate of patients in the absence of immediate management. Our observation concerned a 32-year-old gestant, G3P1 (without living children), with a history of interstitial EP dating back to 3 years during which a uterine wedge resection was performed. For this patient, a prophylactic caesarean was recommended between 36 and 37 weeks of amenorrhea. The patient presented during her prenatal follow-up at 37 weeks and 6 days, a complete uterine rupture involving the right uterine horn with the death of a fetus weighing 2900g. The rupture extended throughout the uterine horn, with the right uterine pedicle intact and the right fallopian tube absent. A conservative treatment of the uterus was decided since the patient had no living children. The purpose of our observation is to recall the risk of uterine rupture after cornual uterine excision hence the importance of performing during a EP if possible, a salpingectomy at the level of the uterine horn and if necessary coagulate the intramural portion of the tube. And also in case of uterine wedge resection, to hasten the prophylactic caesarean section as soon as sufficient maturity of the fetus to reduce the incidence of this pregnancy complication.

Published in Journal of Gynecology and Obstetrics (Volume 9, Issue 4)
DOI 10.11648/j.jgo.20210904.19
Page(s) 136-138
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Uterine Rupture, Interstitial EP, Uterine Wedge Resection, Scar Uterus

References
[1] Nkwabong E, Kouam L, Takang W. Spontaneous uterine rupture during pregnancy: case report and review of literature. Afr J Reprod Health. 2007 Aug; 11 (2): 107-12.
[2] Kiseli M, Artas H, Armagan F, Dogan Z. Spontaneous rupture of uterus in midtrimester pregnancy due to increased uterine pressure with previous laparoscopic myomectomy. Int J Fertil Steril. 2013 Oct; 7 (3): 239-42.
[3] Huang YT, Yim SL, Kapurubandara S, Anpalagan A. Antepartum uterine rupture at 29 weeks’ gestation following unilateral salpingectomy and review of literature. BMJ Case Rep. 2017 Mar 15; 2017. pii: bcr2015211359. doi: 10.1136/bcr-2015-211359.
[4] Stanirowski PJ, Trojanowski S, Słomka A, Cendrowski K, Sawicki W Spontaneous rupture of the pregnant uterus following salpingectomy: a literature review. Gynecol Obstet Invest. 2015; 80 (2): 73-7. doi: 10.1159/000398795.
[5] Tulandy T, Al-jaroudi. Interstitial pregnancy: results generated from the society of reproductive surgeon’s registry. Obstet Gynecol 2004; 103: 47-50.
[6] Boutten A, Debodinance P. La grossesse angulaire diagnostiquée à 11 semaines sur un utérus fibromateux à propos de 1 cas. J Gynecol Obstet Reprod 2006: 82-6.
[7] Loué VA, Dia JM, Effoh DN, Adjoby RC, Konan JK, Gbary EA, Abauleth RY, Kouakou F, Boni SE. Management and prognosis of uterine rupture during labor in an under-medicalized country: about 513 cases collected at the Cocody University Hospital Center (Abidjan-Côte d'Ivoire). Int J Reprod Contracept Obstet Gynecol 2015; 4: 1277-82.
[8] Bretones S, Cousin C, Gualandi M, Mellier G. Rupture utérine à propos d’un cas de rupture spontanée à 30 SA chez une primipare. J Gynecol Obstet Biol Reprod 1997; 26: 324-7.
[9] Schrinsky DC Benson RC. Rupture of the pregnant uterus: a review. Obstet Gynecol Surv 1978; 33: 217-32.
[10] Spaulding LB, Gallup DG. Current concepts of management of ruptures of the gravid uterus. Obstet gynecol 1979; 54: 437-41.
[11] Moawad NS, Mahajan ST, Moniz MH, et al. Current diagnosis and treatment of interstitial pregnancy. Am J Obstet Gynecol 2010; 202: 15-29.
[12] Jourdain O, Fontanges M, Schiano A, Rauch F, Gonnet J-M. Recommandations pour la pratique clinique. Prise en charge des autres ectopies annexielles (cornuale, interstitielle, angulaire, ovarienne). J Gynecol Ostet Reprod 2003; 32 (suppl.): 3S93-3S100.
[13] Lizan G, Crouet H, Levy G. Rupture of the pregnant uterus horn following salpingectomy with resection of the interstitial portion. Report of 3 cases of which one followed in vitro fertilization and embryo transfer. J Gynecol 1986; 15: 641–6.
[14] Soriano D, Vicus D, Mashiach R, et al. Laposcopic treatment of cornual pregnancy: a seriers of 20 consecutive cases. Fertil Steril 2008; 90: 839-43.
[15] Meyer WR, Mitchell DE. Hysteroscopic removal of an interstitial ectopic gestation. A case report. J Reprod Med 1989; 34: 928-9.
[16] Gautier C, Van Belle Y, Van Bogaert LJ, De Muylder E. Rupture utérine. Réflexion à propos d’un cas spontané à mi-grossesse J Gynecol Obstet Biol Reprod 1985; 14: 201–9.
[17] Merviel P, Lourde E, Gagneur O, Nasreddine A, Brzakowski M, Urrutiaguer S. et al. Grossesse extra-utérines. Traitement chirurgical: techniques, avantages et inconvénients. CNGOF, Paris 2010: 61-74.
[18] Hayata E, Tsuchiya T, Maemura T, Yukiko Katagiri, Hasegawa T, Morita M. Recurrent Ectopic Pregnancy in the Remnant Fallopian Tube Following Ipsilateral Partial Salpingectomy. Open Journal of Obstetrics and Gynecology, 2015, 5: 373-7.
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  • APA Style

    Koffi Soh Victor, Kouakou-Kouraogo Ramata, Loba Okoin Paul Jose, Akobe Privat, Konan Koffi Joachim, et al. (2021). An Unusual Case of Spontaneous Uterine Rupture After a Salpingectomy Following an Interstitial Ectopic Pregnancy. Journal of Gynecology and Obstetrics, 9(4), 136-138. https://doi.org/10.11648/j.jgo.20210904.19

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    ACS Style

    Koffi Soh Victor; Kouakou-Kouraogo Ramata; Loba Okoin Paul Jose; Akobe Privat; Konan Koffi Joachim, et al. An Unusual Case of Spontaneous Uterine Rupture After a Salpingectomy Following an Interstitial Ectopic Pregnancy. J. Gynecol. Obstet. 2021, 9(4), 136-138. doi: 10.11648/j.jgo.20210904.19

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    AMA Style

    Koffi Soh Victor, Kouakou-Kouraogo Ramata, Loba Okoin Paul Jose, Akobe Privat, Konan Koffi Joachim, et al. An Unusual Case of Spontaneous Uterine Rupture After a Salpingectomy Following an Interstitial Ectopic Pregnancy. J Gynecol Obstet. 2021;9(4):136-138. doi: 10.11648/j.jgo.20210904.19

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  • @article{10.11648/j.jgo.20210904.19,
      author = {Koffi Soh Victor and Kouakou-Kouraogo Ramata and Loba Okoin Paul Jose and Akobe Privat and Konan Koffi Joachim and Soro Ngolo Alassane and Gbary-Lagaud Eleonore and Adjoby Cassou Roland},
      title = {An Unusual Case of Spontaneous Uterine Rupture After a Salpingectomy Following an Interstitial Ectopic Pregnancy},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {9},
      number = {4},
      pages = {136-138},
      doi = {10.11648/j.jgo.20210904.19},
      url = {https://doi.org/10.11648/j.jgo.20210904.19},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20210904.19},
      abstract = {Spontaneous uterine rupture following a history of surgical treatment of an interstitial tubal ectopic pregnancy (EP) is a rare clinical form. This uterine rupture occurring after a wedge resection of the uterine horn, is a serious obstetric complication involving maternal and fetal vital prognosis and obstetric fate of patients in the absence of immediate management. Our observation concerned a 32-year-old gestant, G3P1 (without living children), with a history of interstitial EP dating back to 3 years during which a uterine wedge resection was performed. For this patient, a prophylactic caesarean was recommended between 36 and 37 weeks of amenorrhea. The patient presented during her prenatal follow-up at 37 weeks and 6 days, a complete uterine rupture involving the right uterine horn with the death of a fetus weighing 2900g. The rupture extended throughout the uterine horn, with the right uterine pedicle intact and the right fallopian tube absent. A conservative treatment of the uterus was decided since the patient had no living children. The purpose of our observation is to recall the risk of uterine rupture after cornual uterine excision hence the importance of performing during a EP if possible, a salpingectomy at the level of the uterine horn and if necessary coagulate the intramural portion of the tube. And also in case of uterine wedge resection, to hasten the prophylactic caesarean section as soon as sufficient maturity of the fetus to reduce the incidence of this pregnancy complication.},
     year = {2021}
    }
    

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    T1  - An Unusual Case of Spontaneous Uterine Rupture After a Salpingectomy Following an Interstitial Ectopic Pregnancy
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    AB  - Spontaneous uterine rupture following a history of surgical treatment of an interstitial tubal ectopic pregnancy (EP) is a rare clinical form. This uterine rupture occurring after a wedge resection of the uterine horn, is a serious obstetric complication involving maternal and fetal vital prognosis and obstetric fate of patients in the absence of immediate management. Our observation concerned a 32-year-old gestant, G3P1 (without living children), with a history of interstitial EP dating back to 3 years during which a uterine wedge resection was performed. For this patient, a prophylactic caesarean was recommended between 36 and 37 weeks of amenorrhea. The patient presented during her prenatal follow-up at 37 weeks and 6 days, a complete uterine rupture involving the right uterine horn with the death of a fetus weighing 2900g. The rupture extended throughout the uterine horn, with the right uterine pedicle intact and the right fallopian tube absent. A conservative treatment of the uterus was decided since the patient had no living children. The purpose of our observation is to recall the risk of uterine rupture after cornual uterine excision hence the importance of performing during a EP if possible, a salpingectomy at the level of the uterine horn and if necessary coagulate the intramural portion of the tube. And also in case of uterine wedge resection, to hasten the prophylactic caesarean section as soon as sufficient maturity of the fetus to reduce the incidence of this pregnancy complication.
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Author Information
  • Teaching Hospital Center of Angre, Mother and Child Department, Felix Houphouet Boigny University, Abidjan, Cote d’Ivoire

  • Teaching Hospital Center of Angre, Mother and Child Department, Felix Houphouet Boigny University, Abidjan, Cote d’Ivoire

  • Teaching Hospital Center of Angre, Mother and Child Department, Felix Houphouet Boigny University, Abidjan, Cote d’Ivoire

  • Teaching Hospital Center of Angre, Mother and Child Department, Felix Houphouet Boigny University, Abidjan, Cote d’Ivoire

  • Teaching Hospital Center of Angre, Mother and Child Department, Felix Houphouet Boigny University, Abidjan, Cote d’Ivoire

  • Teaching Hospital Center of Angre, Mother and Child Department, Felix Houphouet Boigny University, Abidjan, Cote d’Ivoire

  • Teaching Hospital Center of Angre, Mother and Child Department, Felix Houphouet Boigny University, Abidjan, Cote d’Ivoire

  • Teaching Hospital Center of Angre, Mother and Child Department, Felix Houphouet Boigny University, Abidjan, Cote d’Ivoire

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