Professional paper

Intrapartal uterine avulsion with posterior cervical rupture

Dubravko Habek orcid.org/0000-0003-1304-9279 ; University Department of Obstetrics and Gynecology Clinical Hospital “Sveti Duh” Sveti Duh 63, 10000 Zagreb, Croatia
Tatjana Pavelić Turudić ; University Department of Obstetrics and Gynecology, Clinical Hospital “Sveti Duh”, Zagreb
Ivan Šklebar ; University Department of Obstetrics and Gynecology, Clinical Hospital “Sveti Duh”, Zagreb

Abstract

In this case study we describe an obstetric emergency of complete intrapartum left-lateral uterine avulsion, with posterior cervical rupture in a 31-year-old secundipara, following vacuum extraction. To the best of our knowledge, a similar case has not been previously reported in the literature. A live macrosomic male neonate was delivered by two tractions, with lateral episiotomy, and with shoulder dystocia that was relieved by McRoberts’ and Resnik’s maneuvers (Apgar score 7.8, birth weight/length 4640/57).

In our patient, the risk factors for avulsion and concomitant posterior cervical rupture included prolonged second stage of labor, delivering a macrosomic neonate in a secundipara with deflexion (parietal) in a cephalic presentation along the distended and thinned posterior uterine wall. Urgent total hysterectomy was performed in dramatical circumstances due to complete unilateral avulsion and cervical rupture, with continuous aortal compression, volume replacement and intact coagulation, which certainly contributed to the good final maternal outcome.

Keywords

delivery; uterine avulsion; uterine rupture

Hrčak ID:

170169

URI

https://hrcak.srce.hr/170169

Publication date:

1.5.2016.

Visits: 1.921 *