EP11.06: Uterine rupture suspected in a primigravida with prior adenomyomectomy: a case report at 27 weeks of gestation

A 36-year-old primigravida at 27 weeks and 5 days of gestation presented to the emergency room with persistent abdominal distension. She had a history of adenomyomectomy performed 2 years ago at another hospital, with an unremarkable prenatal course in the current pregnancy. On admission, she had mild vaginal bleeding, no uterine contractions, and a reassuring fetal status. However, ultrasound revealed a near-absent amniotic fluid volume and a new cystic mass approximately 10cm above the uterus. The cystic mass was suspected to be a uterine rupture related to the prior adenomyomectomy, rather than an ovarian cyst-associated amnion rupture. The surgical findings also revealed that the amniotic sac protruded like a cystic lesion due to uterine fundus rupture following a previous adenomyomectomy. This case highlights the importance of considering uterine structural abnormalities in pregnant women with a history of uterine surgery, and the need for careful monitoring and intervention in such cases to ensure optimal maternal and fetal outcomes. With the increasing maternal age in recent years, the occurrence of uterine myomas or adenomyosis before pregnancy has become quite common. However, it is important to note that undergoing surgery for these conditions before pregnancy is actually considered very risky. It is advisable to manage these conditions conservatively with careful monitoring during pregnancy. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.