A womb like a broken heart

BMJ Case Reports
Amenda Ann Davis

Abstract

Uterine perforation during hysteroscopic operative procedures is a potential complication well known to gynaecologists. Uterine septa are a commonly encountered Müllerian anomaly related to pregnancy loss and infertility. Hysteroscopic resection of septa has shown to improve pregnancy outcome. There are limited case reports of uterine rupture in subsequent pregnancies after hysteroscopic septal resection. Our patient had a hysteroscopic septal resection done a year prior which was complicated by a uterine fundal perforation, left to spontaneously heal after immediate sealing with cautery. The patient conceived spontaneously soon after and underwent an emergency caesarean section for severe pre-eclampsia. Intraoperatively, after removal of the placenta, we discovered a 3 cm symmetrical circular defect at the fundus of the uterus with no myometrium or serosa. The potentially disastrous consequences of this silent uterine rupture were mitigated due to another life-threatening condition which prevented the onset of labour.

References

Jun 1, 1993·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·A J Nordin, J A Richardson
Jun 1, 1994·American Journal of Obstetrics and Gynecology·D C SmithS J Waszak
Jan 13, 2000·Fertility and Sterility·H A HomerI D Cooke
Jul 26, 2000·Obstetrics and Gynecology·F W JansenT C Trimbos-Kemper
Mar 2, 2002·Fertility and Sterility·Prokopis KerimisHoward Carp
Feb 21, 2003·European Journal of Obstetrics, Gynecology, and Reproductive Biology·R ContursoA Tenore
Jun 1, 2005·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Loïc SentilhesLoïc Marpeau
Jan 2, 2013·International Journal of Surgery Case Reports·Mete ErgenogluSait Yucebilgin

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