Obstet Gynecol Sci.  2015 Nov;58(6):518-521. 10.5468/ogs.2015.58.6.518.

Two pregnancy cases of uterine scar dehiscence after laparoscopic myomectomy

• Song SY
• Yoo HJ
• Kang BH
• Ko YB
• Lee KH
• Lee M

• KMID: 2314070
• DOI: http://doi.org/10.5468/ogs.2015.58.6.518

Abstract

Uterine scar dehiscence following laparoscopic myomectomy rarely occurs but can compromise both maternal and fetal well-being in subsequent pregnancy. We here present two cases of pregnancy complicated by preterm birth that resulted from uterine scar dehiscence following laparoscopic myomectomy. First case was a nulligravida who had scar dehiscence at 26 weeks of gestation after having a laparoscopic myomectomy 3 months prior to conception. Two weeks later, we observed her fetal leg protruding through the defect. The other case was a primigravida with a history of prior cesarean delivery, whose sonography revealed myomectomy scar dehiscence at 31 weeks of gestation. Within a few hours after observing, the patient complained of abdominal pain that was aggravating as fetal leg protruded through the defect. In both cases, babies were born by emergency cesarean section. Conservative management can be one of treatment options for myomectomy scar dehiscence in preterm pregnancy. However, clinicians should always be aware of the possibility of obstetric emergencies.

Keyword

Surgical scar dehiscence; Uterine myomectomy; Uterine rupture

MeSH Terms

Abdominal Pain
Cesarean Section
Cicatrix*
Emergencies
Female
Fertilization
Humans
Leg
Pregnancy*
Premature Birth
Uterine Myomectomy
Uterine Rupture

Figure

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  Fig. 1 The newborn's left leg shows bruise and edema.

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  Fig. 2 Uterine wall dehiscence. (A) Ultrasonography showed the protrusion of the amniotic sac through the uterine defect. (B) Photograph of the uterine defect.

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