Spontaneous unscarred uterine rupture in a twin pregnancy complicated by adenomyosis

Xuqing Li, Caihua Li, Meiguo Sun, Mei-Guo Sun, Hongyan Li, Yunxia Cao, Zhaolian Wei
Medicine · 2021 · vol. 100(3) , pp. e24048 · doi:10.1097/md.0000000000024048 · PMID:33546004 · W3126005611
article OA: gold CC0 ⤵ 7 in-corpus citations
🔓 Open OA copy View on OpenAlex View on PubMed View at publisher

Abstract

INTRODUCTION: Uterine rupture during pregnancy is a serious obstetric complication accompanied by a high incidence of maternal morbidity and mortality, and the presence of uterine scars is the main risk factor. In the present case, uterine rupture occurred in an unscarred uterus in a nonlaboring primigravida woman with adenomyosis and twin pregnancy in the third trimester. PATIENT CONCERNS: In this case, the patient suspected to have a history of endometriosis have got twin pregnancies following intracytoplasmic sperm injection, and complained of recurrent lower abdominal pain from 16 weeks to 29 weeks of gestation. DIAGNOSIS: After exploratory laparotomy, the patient was diagnosed with uterine rupture and adenomyosis. INTERVENTIONS: The patient was first administered expectant treatment such as antibiotics, tocolytics, and fluid replacement therapy. Symptoms then appeared repeatedly and worsened, followed by eventual peritoneal irritation, and exploratory laparotomy was performed. OUTCOMES: Two live female fetuses were extracted by cesarean section, and the uterine laceration was repaired. The mother recovered without any postoperative complications, and the babies were discharged after receiving one month of prematurity care without any postnatal complications. CONCLUSION: Adenomyosis and the conception of twins may lead to uterine rupture. For pregnant women with a history of adenomyosis with multiple gestations, close monitoring for signs of uterine rupture is necessary. Single-embryo transfer and multifetal pregnancy reduction should be recommended for infertile patients with adenomyosis.

My notes (saved in your browser only)

Condition tags

endometriosisadenomyosis

MeSH descriptors

Adenomyosis Pregnancy Complications Pregnancy, Twin Premature Birth Uterine Rupture Adenomyosis Adult Cesarean Section Female Humans Live Birth Pregnancy Pregnancy Complications Pregnancy Trimester, Third Premature Birth Rupture, Spontaneous Uterine Rupture

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (32)

Cited by (7)

Source provenance

europepmc
last seen: 2026-06-04T01:30:01.192114+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pubmed
last seen: 2026-05-13T22:24:55.077982+00:00
License: CC0 · commercial use OK