Successful management of the recurrent uterine rupture after the uterine septum resection

Abstract

Uterine septum is associated with an increased rate of recurrent miscarriages which can be reduced significantly by performing endoscopic resection. Perinatal outcome improvement due to resection is favorable but still remains controversial. Uterine rupture is a late complication of hysteroscopic surgery that may be a life-threatening condition in terms of perinatal and maternal morbidity–mortality. This article presents the first case of the related literature dealing with the successful management of the third recurrent uterine rupture in the 31st week of pregnancy subsequent to the hysteroscopic resection of uterine septum. The patient observed in this article had experienced uterine rupture twice; firstly, in the 27th week of pregnancy resulted with postpartum exitus and secondly, in the 29th week of pregnancy that ended with stillbirth while her last pregnancy eventuated in a live healthy birth. Surgeons who accomplish these hysteroscopic procedures must weigh out pros and cons; and must also acquaint their patients with the probable risk of recurrent and multiple uterine ruptures during the subsequent pregnancy. Keywords: Recurrent miscarriage, Uterine malformation, Uterine septum, Hysteroscopic resection, Uterine rupture in subsequent pregnancy, Resectoscope, Recurrent uterine rupture