Combined vesicouterine rupture during second-trimester medical abortion for fetal abnormality after prior cesarean delivery: A case report

Giuseppe Caruso; Vanessa Paladini; Valentina D'ambrosio; Antonella Giancotti; Maria Grazia Piccioni; Innocenza Palaia; Violante Di Donato; Giorgia Perniola; Roberto Brunelli; Francesco Pecorini; Ludovico Muzii; Maria Scudo

Case Reports in Women's Health (Oct 2021)

Combined vesicouterine rupture during second-trimester medical abortion for fetal abnormality after prior cesarean delivery: A case report

Giuseppe Caruso,
Vanessa Paladini,
Valentina D'ambrosio,
Antonella Giancotti,
Maria Grazia Piccioni,
Innocenza Palaia,
Violante Di Donato,
Giorgia Perniola,
Roberto Brunelli,
Francesco Pecorini,
Ludovico Muzii,
Maria Scudo

Affiliations

Giuseppe Caruso: Corresponding author at: Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy.; Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
Vanessa Paladini: Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
Valentina D'ambrosio: Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
Antonella Giancotti: Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
Maria Grazia Piccioni: Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
Innocenza Palaia: Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
Violante Di Donato: Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
Giorgia Perniola: Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
Roberto Brunelli: Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
Francesco Pecorini: Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
Ludovico Muzii: Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
Maria Scudo: Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy

Journal volume & issue: Vol. 32
p. e00364

Abstract

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Introduction: The use of mifepristone and misoprostol for the induction of a second-trimester abortion is common and effective. However, its safety in women with previous cesarean delivery is still controversial, given the potentially higher risk of uterine rupture. Case presentation: We present the case of a 30-year-old woman (G2P1) who experienced vesicouterine rupture with escape of the dead fetus into the bladder during second-trimester induced abortion after prior cesarean delivery. She was successfully managed with conservative surgery. Conclusion: This case highlights the challenges of early diagnosis of vesicouterine rupture during second-trimester medical abortion. We argue that a close monitoring of patients with prior cesarean section is mandatory, particularly if uterine contractions suddenly stop or the fetal head fails to descend. A prompt conservative surgical approach allows preservation of fertility.

Published in Case Reports in Women's Health

ISSN: 2214-9112 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Surgery; Medicine: Gynecology and obstetrics
Website: http://www.journals.elsevier.com/case-reports-in-womens-health/

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