Intrapartum uterine rupture associated with a scarred cervix because of a previous rupture of cystic cervical endometriosis
Journal
Taiwanese Journal of Obstetrics and Gynecology
Journal Volume
50
Journal Issue
1
Pages
95-97
Date Issued
2011
Author(s)
MING CHEN
Abstract
Endometriosis is defined as the growth of ectopic endometrial tissue beyond the uterine cavity. The incidence of endometriosis has been reported to range from 4% to 17% in all women of reproductive age. The most commonly reported presentations of endometriosis are dysmenorrhea, dyspareunia, pelvic pain, and infertility. Most endometrial deposits are confined to the pelvis but extrapelvic endometriosis has also been occasionally documented in the literature [1]. Cervical endometriosis is an uncommon and generally asymptomatic condition. We report an extremely rare case of intrapartum uterine rupture through the scar of the previously ruptured cystic cervical endometriosis. A 33-year-old nulliparous woman visited our clinic in 2003 because of lower abdominal pain. She had a history of laparoscopic cystectomy because of bilateral ovarian endometriomas in 2000. Dysmenorrhea recurred 2 years after the operation. Transvaginal sonography at our clinic revealed a homogeneous cyst measuring approximately 3 cm 4 cm over the posterior endocervix (Fig. 1). Abdominal sonography showed a fluidfilled cervical cyst. The patient presented at our emergency department a few hours after her initial visit to our clinic because of lower abdominal pain and persistent vaginal bleeding. She denied having undergone sexual intercourse or trauma before the vaginal bleeding began. Speculum examination revealed a ruptured cystic lesion approximately 2 cm 2 cm with active bleeding over the posterior lip of the cervix (5-o��clock direction) near the vaginocervical junction without extending to the external orifice of the cervix. Chocolate-like fluid also flowed out from the wound, and cervical endometriosis was suspected. We removed the fragile cyst wall
SDGs
Type
journal article