Successful outcome of pregnancy and delivery after surgical correction in a patient with complete uterine rupture
Makiyan Z.N., Tetruashvili N.K., Adamyan L.V., Gus A.I., Bychenko V.G.
Background: Complete uterine rupture is a serious complication that poses significant difficulties in reconstructive surgery. The results are frequently disappointing due to the high probability of postoperative scar defect and cervical canal atresia which eventually lead to hysterectomy.
Case report: The present case report details a rare clinical observation of a favorable outcome of pregnancy and childbirth as a result of surgical treatment, namely uterocervical junction after complete detachment of the uterus from the cervix. Magnetic resonance imaging was used for the diagnosis and preoperative modelling of the anatomy of the internal genitalia. Operative treatment was completely performed through laparoscopic access. There were the following important issues: mobilization and anatomization of the separated (dislocated) segments of the cervix and uterus, excision of scar tissue, suturing through all layers of myometrium, matching of segments and reconstitution of uterine anatomy. The regeneration period of the postoperative scar was 12 months. The patient became pregnant 6 months after she stopped taking contraception and underwent progesterone support and Arabin pessary placement. The patient underwent caesarean section at 35 weeks gestation after a course of prophylaxis for fetal respiratory distress syndrome. No visible defects were found during the exploration of the postoperative scar area.
Conclusion: The presented rare clinical observation of complete uterine rupture due to severe trauma showed the high informative value of imaging diagnosis before planning surgery. Reconstructive surgery, therapy aimed at prolonging pregnancy, and timely delivery contributed to the successful outcome, resulting in the birth of a healthy baby.
Authors’ contributions: Makiyan Z.N., Tetruashvili N.K., Adamyan L.V., Gus. A.I., Bychenko V.G. – performing the operation, developing the design and concept of the study, collecting data on the issue, analysis of the obtained results, writing the article, editing the article.
Conflicts of interest: Authors declare lack of the possible conflicts of interest.
Funding: The study was carried out without sponsorship.
Patient Consent for Publication: The patient provided an informed consent for the publication of her data and associated images.
For citation: Makiyan Z.N., Tetruashvili N.K., Adamyan L.V., Gus A.I., Bychenko V.G. Successful outcome of
pregnancy and delivery after surgical correction in a patient with complete uterine rupture.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (5): 195-200 (in Russian)
https://dx.doi.org/10.18565/aig.2025.24
Keywords
complete uterine detachment
uterine rupture
metroplasty
uterine scar defect
caesarean section
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Received 07.02.2025
Accepted 06.05.2025
About the Authors
Zograb N. Makiyan, Dr. Med. Sci., Leading Researcher at the Department of Operative Gynecology, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 4, Oparin str., Moscow, 117997, Russia, makiyan@mail.ru, https://orcid.org/0000-0002-0463-1913Nana K. Tetruashvili, Dr. Med. Sci., Head of the 2nd Obstetric Department of Pregnancy Pathology, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 4, Oparin str., Moscow, 117997, Russia, tetrauly@mail.ru, https://orcid.org/0000-0002-9201-2281
Leyla V. Adamyan, Dr. Med. Sci., Professor, Academician of the Russian Academy of Sciences, Head of the Gynecological Department,
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 4, Oparin str., Moscow,
117997, Russia, adamyanleila@gmai.com, https://orcid.org/0000-0002-3253-4512
Aleksandr I. Gus, Dr. Med. Sci., Professor, Chief Researcher at the Department of Ultrasound and Functional Diagnostics, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 4, Oparin str., Moscow, 117997, Russia, aleksandr_gus@mail.ru,
https://orcid.org/0000-0003-1377-3128
Vladimir G. Bychenko, PhD, Head of the Department of Radiation Diagnostics, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 4, Oparin str., Moscow, 117997, Russia, v_bychenko@yandex.ru, https://orcid.org/0000-0002-1459-4124
Corresponding author: Zograb N. Makiyan, makiyan@mail.ru
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