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.

Combined vesicouterine rupture during second-trimester medical abortion for fetal abnormality after prior cesarean delivery: a case report / Caruso, G.; Paladini, V.; D'ambrosio, V.; Giancotti, A.; Piccioni, M. G.; Palaia, I.; Di Donato, V.; Perniola, G.; Brunelli, R.; Pecorini, F.; Muzii, L.; Scudo, M.. - In: CASE REPORTS IN WOMEN'S HEALTH. - ISSN 2214-9112. - 32:(2021). [10.1016/j.crwh.2021.e00364]

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

Caruso G.
;
Paladini V.;D'ambrosio V.;Giancotti A.;Piccioni M. G.;Palaia I.;Di Donato V.;Perniola G.;Brunelli R.;Pecorini F.;Muzii L.;Scudo M.
2021

Abstract

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.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1590259
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