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Abstract
RÉSUMÉ
La rupture utérine est une complication obstétricale grave, particulièrement chez les femmes porteuses d’un utérus cicatriciel. Elle demeure fréquente dans les pays à ressources limitées du fait de l’insuffisance du suivi prénatal. Nous rapportons le cas d’une patiente de 23 ans, G3P2, avec antécédent de césarienne par hystérotomie segmentaire verticale, admise pour anémie sévère sur grossesse estimée à 6 mois, compliquée d’une rupture utérine en cours de travail. La laparotomie d’urgence a mis en évidence une déhiscence de la cicatrice utérine associée à une grossesse gémellaire bichoriale biamniotique, avec décès fœtal in utero. Une hystérorraphie en deux plans a été réalisée avec suites opératoires simples. Ce cas souligne l’importance du suivi prénatal et de la surveillance stricte des grossesses sur utérus cicatriciel.
ABSTRACT
Uterine rupture is a serious obstetric complication, particularly in women with a scarred uterus. It remains common in resource-limited countries due to inadequate prenatal care. We report the case of a 23-year-old woman, 3 weeks pregnant, with a history of cesarean section via vertical segmental hysterotomy, admitted for severe anemia during a pregnancy estimated at 6 months, complicated by uterine rupture during labor. Emergency laparotomy revealed dehiscence of the uterine scar associated with a dichorionic diamniotic twin pregnancy, with intrauterine fetal death. A two-layer hysteroplasty was performed with an uncomplicated postoperative course. This case highlights the importance of prenatal care and close monitoring of pregnancies in women with a uterine scar.
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References
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- 8. Rostaminia G, Caughey AB, Gharib S, et al.Risk of uterine by prior cesarean delivery incision type : systematic review. BJOG. 2022: 129(3): 293-302.
- 9. Brito LG, Passini R Jr, Cecatti JG. Uterine rupture in low-and middle-income countries: a systematic review. BJOG.2022;129(6): 937-45.
- 10. World Health Organization (WHO). WHO recommendation on antenatal care for a positive pregnancy experience.Geneva: WHO; Available from: https://www.who.int/publications/i/item/9789241549950
- 11. Motomura K, Ganchimeg T Nagata C,et al.Incidence and outcomesof uterine rupture among women with prior caesarean section: WHO Multicountry Survey.BJOG.2020;127(7):859-68.
- 12. Guisse JM,Denman MA, Emeis C,et al. Vaginal brith after cesarean: new insights on maternal and neonatal outcomes.Obtstet Gynecol.2020;135(5):1111-27.
- 13. Fitzpatrick KE, Kurinczuk JJ, Alfirevic Z, Spark P,et al. Uterine rupture by intended mode of delivery in the UK: a national case- control study.PLoS Med.2019;16(4):e1002994.
References
1. MSD Manuals Professional Edition. Rupture utérine. Mise á jour2024.Disponible sur: https://www.msdmanuals.com/fr/professional/gynécologie-et-obstétrique/complication-intrapartum/rupture-utérine
2. Mutiso SK, Muthama NM,Njagi J. Spontaneous uterine rupture in pregnancy: a case report and review of the literature. J Med Case Rep. 2023; 17(1): 432.Disponible sur: https://jmedicalcasereports.biomedcentral.com/article/10.1186/s13256-023-04318-w
3. Astatikie G, Limenih MA,Kebede SA.Uterine rupture : risk factors,maternal and fetal outcomes.J Clin Med.2024;13(14): 4987.Disponible sur: https://www.mdpi.com/2077-0383/13/14/4987.
4. Zwart JJ, Richters JM, Ory F et al. Uterine rupture in low- and middle- income countries: incidence,risk factors and outcomes.BMC Pregnancy Childbirth.2022;22:745. Disponiblesur: https://bmcpregnancychilbirth.biomedcentral.com/article/10.1186/s12884-022-05012-1
5. American College of Obstetricians and Gynecologists (ACOG). Trial of labor after cesarean delivery: clinical management guideline. Obstet Gynecol.2021;137(2):e110-e127.
6. Say L, Chou D, Gemmill A, et al.Global causes of maternaldeath:a WHO systematic analysis. Lancet et Glob Health 2021;9(3):e323-e333.
7. knight M,Nair M, Tuffnell D, et al.Saving Lives, Improving Mothers’ Care: Lessons learned to inform maternity care form the UK and Ireland Confidential Enquiries intro Maternal Deaths and Morbidity 2019- 2021.Oxford: National Perinatal Epidemiology Unit,University of Oxford ;2023.
8. Rostaminia G, Caughey AB, Gharib S, et al.Risk of uterine by prior cesarean delivery incision type : systematic review. BJOG. 2022: 129(3): 293-302.
9. Brito LG, Passini R Jr, Cecatti JG. Uterine rupture in low-and middle-income countries: a systematic review. BJOG.2022;129(6): 937-45.
10. World Health Organization (WHO). WHO recommendation on antenatal care for a positive pregnancy experience.Geneva: WHO; Available from: https://www.who.int/publications/i/item/9789241549950
11. Motomura K, Ganchimeg T Nagata C,et al.Incidence and outcomesof uterine rupture among women with prior caesarean section: WHO Multicountry Survey.BJOG.2020;127(7):859-68.
12. Guisse JM,Denman MA, Emeis C,et al. Vaginal brith after cesarean: new insights on maternal and neonatal outcomes.Obtstet Gynecol.2020;135(5):1111-27.
13. Fitzpatrick KE, Kurinczuk JJ, Alfirevic Z, Spark P,et al. Uterine rupture by intended mode of delivery in the UK: a national case- control study.PLoS Med.2019;16(4):e1002994.