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An Unusual Cause of Uterine Rupture - A Case Report
Abstract
OBJECTIVE: To revel the effect of trauma during pregnancy
CASE REPORT: Mrs. L.P. was a booked 28-year old para1+0, trader who in her last confinement in 2001 had a lower uterine segment caesarean section for prolonged labour. Her post-operative period was said to have been complicated by wound sepsis necessitating a prolonged hospital stay. The outcome of that pregnancy was a live male baby.
She presented at the Accident and Emergency department of the University of Port Harcourt Teaching Hospital on the 2nd of May 2003 at a gestational age of 31 weeks with the complaints of severe abdominal pains and dizziness of 4 hours duration. She claimed to have been hit on her abdomen inadvertently while separating a fight amongst her neighbours.
RESULT: On examination, she was in painful distress, restless and pale. Her pulse rate was 120 beats per minute and thready while her blood pressure was 80/50mmHg. The abdomen was gravidly enlarged and distended with a subumblical midline scar that appeared to have healed by secondary intention. The abdomen was very tender and the liver, spleen and kidneys could not be palpated. The fetal heart sound was present with a rate of 160 beats per minute. There was evidence of intra peritoneal fluid collection. Vaginal examination revealed a normal vulva and vagina. There was no vaginal bleeding. The cervix was uneffaced and the OS was closed. The vaginal fornices were tender. An impression of ruptured viscus with hypovolenic shock
The baby was still alive at the time of delivery due to cushion-effect of the amniotic fluid but had early neonate death because of severe asphyxia and complications of prematurity. Other workers have found that fetal demise is more common when maternal injuries include trauma to the uterus 8-10.
CONCLUSION: Pregnant women especially those in the third trimester with a previous caesarean section should avoid separating physical fight involving neighbours and others so as to avoid the tragedy of trauma to the uterus and its consequences.
Nig Jnl Orthopaedics & Trauma Vol.2(2) 2003: 127-129
CASE REPORT: Mrs. L.P. was a booked 28-year old para1+0, trader who in her last confinement in 2001 had a lower uterine segment caesarean section for prolonged labour. Her post-operative period was said to have been complicated by wound sepsis necessitating a prolonged hospital stay. The outcome of that pregnancy was a live male baby.
She presented at the Accident and Emergency department of the University of Port Harcourt Teaching Hospital on the 2nd of May 2003 at a gestational age of 31 weeks with the complaints of severe abdominal pains and dizziness of 4 hours duration. She claimed to have been hit on her abdomen inadvertently while separating a fight amongst her neighbours.
RESULT: On examination, she was in painful distress, restless and pale. Her pulse rate was 120 beats per minute and thready while her blood pressure was 80/50mmHg. The abdomen was gravidly enlarged and distended with a subumblical midline scar that appeared to have healed by secondary intention. The abdomen was very tender and the liver, spleen and kidneys could not be palpated. The fetal heart sound was present with a rate of 160 beats per minute. There was evidence of intra peritoneal fluid collection. Vaginal examination revealed a normal vulva and vagina. There was no vaginal bleeding. The cervix was uneffaced and the OS was closed. The vaginal fornices were tender. An impression of ruptured viscus with hypovolenic shock
The baby was still alive at the time of delivery due to cushion-effect of the amniotic fluid but had early neonate death because of severe asphyxia and complications of prematurity. Other workers have found that fetal demise is more common when maternal injuries include trauma to the uterus 8-10.
CONCLUSION: Pregnant women especially those in the third trimester with a previous caesarean section should avoid separating physical fight involving neighbours and others so as to avoid the tragedy of trauma to the uterus and its consequences.
Nig Jnl Orthopaedics & Trauma Vol.2(2) 2003: 127-129
