Fetus ruptures uterus with protruded legs in a large amniocele

Ruptured Pregnancy
Source: NEJM

Case of ruptured pregnancy

This article describes the case of a 33-year-old asymptomatic woman who presented to the clinic with a large herniation of the amniotic sac and ruptured pregnancy. The herniation was detected during routine ultrasonography. The woman was in her 22nd week of gestation and showed no concerning findings on examination. According to the case report published in the New England Journal of Medicine, the fetus ruptured the mother’s uterus by popping a part of its body through the uterine wall.

Doctors advised magnetic resonance imaging which showed that the uterine wall had a 2.5 centimetre or 1 inch long rupture. Imaging showed that the amniotic sac had herniated, with the fetus’s abdomen and legs poking through. The woman was under treatment at the Angers University Hospital in France. The doctors there had never seen anything like it before, leaving them baffled. The patient’s medical history revealed that she had undergone five caesarean sections in the past.

A possible explanation for this unusual medical case is that the multiple c-sections may have weakened the uterine wall. However, the scar tissue for these procedures was not found in the same locations as the site of the rupture. This is referred to as a ruptured pregnancy. It is known to affect less than 5 in 1,000 pregnant women who have previously given birth via c-sections. In addition, the risk is seen to be notably low in first-time pregnancies and in women who do not have a history of c-sections.

Although a rare phenomenon, it is associated with several life-threatening complications.

The mother gave birth to a 1.4 kg (3 pound) via a remarkably uncomplicated c-section in the 30th week of gestation. The uterine rupture and amniocele were identified and repaired via surgery after birth. She was discharged from the hospital after five days. At 6 months follow-up, the boy was fit and healthy.

Source: NEJM

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Dr. Aiman Shahab is a dentist with a bachelor’s degree from Dow University of Health Sciences. She is an experienced freelance writer with a demonstrated history of working in the health industry. Skilled in general dentistry, she is currently working as an associate dentist at a private dental clinic in Karachi, freelance content writer and as a part time science instructor with Little Medical School. She has also been an ambassador for PDC in the past from the year 2016 – 2018, and her responsibilities included acting as a representative and volunteer for PDC with an intention to make the dental community of Pakistan more connected and to work for benefiting the underprivileged. When she’s not working, you’ll either find her reading or aimlessly walking around for the sake of exploring. Her future plans include getting a master’s degree in maxillofacial and oral surgery, settled in a metropolitan city of North America.


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