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Combined vesicouterine rupture during second-trimester medical abortion for fetal abnormality after prior cesarean delivery: A case report

INTRODUCTION: The use of mifepristone and misoprostol for the induction of a second-trimester abortion is common and effective. However, its safety in women with previous cesarean delivery is still controversial, given the potentially higher risk of uterine rupture. CASE PRESENTATION: We present the...

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Autores principales: Caruso, Giuseppe, Paladini, Vanessa, D'ambrosio, Valentina, Giancotti, Antonella, Piccioni, Maria Grazia, Palaia, Innocenza, Di Donato, Violante, Perniola, Giorgia, Brunelli, Roberto, Pecorini, Francesco, Muzii, Ludovico, Scudo, Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8570940/
https://www.ncbi.nlm.nih.gov/pubmed/34765461
http://dx.doi.org/10.1016/j.crwh.2021.e00364
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author Caruso, Giuseppe
Paladini, Vanessa
D'ambrosio, Valentina
Giancotti, Antonella
Piccioni, Maria Grazia
Palaia, Innocenza
Di Donato, Violante
Perniola, Giorgia
Brunelli, Roberto
Pecorini, Francesco
Muzii, Ludovico
Scudo, Maria
author_facet Caruso, Giuseppe
Paladini, Vanessa
D'ambrosio, Valentina
Giancotti, Antonella
Piccioni, Maria Grazia
Palaia, Innocenza
Di Donato, Violante
Perniola, Giorgia
Brunelli, Roberto
Pecorini, Francesco
Muzii, Ludovico
Scudo, Maria
author_sort Caruso, Giuseppe
collection PubMed
description INTRODUCTION: The use of mifepristone and misoprostol for the induction of a second-trimester abortion is common and effective. However, its safety in women with previous cesarean delivery is still controversial, given the potentially higher risk of uterine rupture. CASE PRESENTATION: We present the case of a 30-year-old woman (G2P1) who experienced vesicouterine rupture with escape of the dead fetus into the bladder during second-trimester induced abortion after prior cesarean delivery. She was successfully managed with conservative surgery. CONCLUSION: This case highlights the challenges of early diagnosis of vesicouterine rupture during second-trimester medical abortion. We argue that a close monitoring of patients with prior cesarean section is mandatory, particularly if uterine contractions suddenly stop or the fetal head fails to descend. A prompt conservative surgical approach allows preservation of fertility.
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spelling pubmed-85709402021-11-10 Combined vesicouterine rupture during second-trimester medical abortion for fetal abnormality after prior cesarean delivery: A case report Caruso, Giuseppe Paladini, Vanessa D'ambrosio, Valentina Giancotti, Antonella Piccioni, Maria Grazia Palaia, Innocenza Di Donato, Violante Perniola, Giorgia Brunelli, Roberto Pecorini, Francesco Muzii, Ludovico Scudo, Maria Case Rep Womens Health Article INTRODUCTION: The use of mifepristone and misoprostol for the induction of a second-trimester abortion is common and effective. However, its safety in women with previous cesarean delivery is still controversial, given the potentially higher risk of uterine rupture. CASE PRESENTATION: We present the case of a 30-year-old woman (G2P1) who experienced vesicouterine rupture with escape of the dead fetus into the bladder during second-trimester induced abortion after prior cesarean delivery. She was successfully managed with conservative surgery. CONCLUSION: This case highlights the challenges of early diagnosis of vesicouterine rupture during second-trimester medical abortion. We argue that a close monitoring of patients with prior cesarean section is mandatory, particularly if uterine contractions suddenly stop or the fetal head fails to descend. A prompt conservative surgical approach allows preservation of fertility. Elsevier 2021-10-27 /pmc/articles/PMC8570940/ /pubmed/34765461 http://dx.doi.org/10.1016/j.crwh.2021.e00364 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Caruso, Giuseppe
Paladini, Vanessa
D'ambrosio, Valentina
Giancotti, Antonella
Piccioni, Maria Grazia
Palaia, Innocenza
Di Donato, Violante
Perniola, Giorgia
Brunelli, Roberto
Pecorini, Francesco
Muzii, Ludovico
Scudo, Maria
Combined vesicouterine rupture during second-trimester medical abortion for fetal abnormality after prior cesarean delivery: A case report
title Combined vesicouterine rupture during second-trimester medical abortion for fetal abnormality after prior cesarean delivery: A case report
title_full Combined vesicouterine rupture during second-trimester medical abortion for fetal abnormality after prior cesarean delivery: A case report
title_fullStr Combined vesicouterine rupture during second-trimester medical abortion for fetal abnormality after prior cesarean delivery: A case report
title_full_unstemmed Combined vesicouterine rupture during second-trimester medical abortion for fetal abnormality after prior cesarean delivery: A case report
title_short Combined vesicouterine rupture during second-trimester medical abortion for fetal abnormality after prior cesarean delivery: A case report
title_sort combined vesicouterine rupture during second-trimester medical abortion for fetal abnormality after prior cesarean delivery: a case report
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8570940/
https://www.ncbi.nlm.nih.gov/pubmed/34765461
http://dx.doi.org/10.1016/j.crwh.2021.e00364
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