Pregnancy Too Soon After Myomectomy- A Case Report

Abstract

Background-Uterine rupture is one of the most inexorable catastrophic obstetric emergencies, it poses a life-threatening condition for the expectant mother and her unborn child and necessitates immediate diagnosis and medical attention. Weakening and scarring of uterine muscle following a myomectomy or post-cesarean delivery are the major identified risk factors for uterine rupture.

Case: 44-year-old female primigravida with DCDA (Dichorionic Diamniotic) twin pregnancy presented with silent uterine rupture at 31 weeks of gestation, it was an in vitro fertilization-embryo transfer 12 months after laparoscopic myomectomy. She visited our hospital in the emergency department with complaints of pain in the abdomen with vaginal spotting.  Emergency cesarean section was performed. During the operation, a rent was seen on fundo posterior uterine wall, towards the right side.

Conclusion- Consensus, and protocol are still looking gloomy regarding the diagnosis and treatment of post-myomectomy scar rupture. The purpose of this case is to highlight the successful outcome of silent rupture of a previous myomectomy scar which was possible due to the identification of its risk factors in pregnancy, early recognition of scar dehiscence or rupture, and timely intervention by experts. Pregnancy after myomectomy, during conception, should be closely monitored concerning uterine rupture.