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Case Report
A case of uterine rupture in second term delivery after septum resection
1 Physician, Department of Obstetrics and Gynecology, Pennsylvania Hospital, 2 Pine East, 800 Spruce Street, Philadelphia, PA, USA
2 Attending Physician, Society Hill Reproductive Medicine, 822 Pine Street, Suite 4B, Philadelphia, PA, USA
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Alexandra Huttler
Department of Ob-Gyn, 2 Pine East, 800 Spruce Street, Philadelphia, PA 19107,
USA
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Article ID: 100116Z08AH2022
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Huttler A, Kelly M. A case of uterine rupture in second term delivery after septum resection. J Case Rep Images Obstet Gynecol 2022;8(1):5–9.ABSTRACT
Introduction: The decision to resect a uterine septum remains individualized. Hysteroscopic approach is the gold standard for uterine septum resection. Uterine rupture in subsequent pregnancy is a known but rare complication without identified methods of prevention.
Case Report: A 32-year-old woman underwent uncomplicated hysteroscopic uterine septum resection followed by uncomplicated term vaginal delivery, with uterine rupture and intrauterine fetal demise at 38 weeks gestational age in the subsequent pregnancy.
Conclusion: Term uterine rupture is possible when the only history of uterine surgery is hysteroscopic septum resection, even with an intervening delivery. Providers should have a low threshold to initiate diagnostic evaluation with fetal or maternal distress in pregnancy after any uterine surgery. Modifiable risk factors for uterine rupture after septum resection may include residual septa, short interval between surgery and pregnancy, and labor induction methodology. Providers should consider these factors when counseling regarding the risks and benefits of resection.
Keywords: Operative hysteroscopy, Uterine rupture, Uterine septum resection
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Author Contributions
Alexandra Huttler - Conception of the work, Design of the work, Acquisition of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Maureen Kelly - Conception of the work, Design of the work, Acquisition of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Alexandra Huttler et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
