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Re: A Case of Uterine RuptureFrom: Malcolm Griffiths (Malcolm@mgriff22.demon.co.uk)Wed Feb 4 14:32:33 1998
In message <199802040438.XAA14353@adam.cheshire.net>, Joanne Bulley <jbulley@cheshire.net> writes > >I had a patient present with a hemoperitoneum at 12 weeks (but no care yet >for this pregnancy - and the dates were in question) she had had 4 prior >terminations "uncomplicated" interspersed with three vag deliveries. The >hemoperitoneum was from a placenta percreta (yes, at 12 weeks) It was >definitively indentified to NOT be a ruptured interstitial pregnancy. The >presumption was there had been a uterine perf with one of the terminations >that was asymptomatic and the pregnancy had implanted at the site of the >prior rupture and this interfered with the normal response of the uterus >preventing the invasion of the trophoblast. I did do a major literature >search and wrote the case up ... but then never sent it in - I probably >could have had it published... > I had a uterine rupture at 16 weeks during sex! Patient had had previous ectopic with salpingectomy (with hindsight I realised the cornua had been "shaved" by the salpingectomy). She arrived collapsed with no measurable vitals. My Intern rang me from ER. I said we'll all meet up in theatre in 60secs! We did and I discovered the fetus "en caul" in the abdo, the uterus was torn from lateral to the Fundus trhough the cornua into the left broad ligament and through the left uterine artery. I closed the uterus and conserved it. SHe got better and wanted to try again for a baby - the husband and I suggested otherwise - she came back for a sterilisation 2mo later. I never got around to writing it up either (happened >12 years ago!). Malcolm Griffiths MD,MRCOG,MFFP,Cert.Mgmnt Obstetrician & Gynaecologist Luton & Dunstable Hosp.,UK. Tel: 01582-497459 (office) Fax: 01582-497376 01525-222849 (home) email: Malcolm@mgriff22.demon.co.uk http://www.obgyn.net/board/griffith.htm "CLINICAL FREEDOM IS THE LAST REFUGE OF THE CLINICALLY INCOMPETENT!" (Someone [1997])
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