Adenomiosis y ruptura uterina espontánea en el segundo trimestre de embarazo: reporte de caso

In: Archivos de Medicina (Manizales) · 2025 · vol. 25(1) · doi:10.30554/archmed.25.1.5313.2025 · W4410350219
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Abstract

Introduction: Adenomyosis is a common gynecological condition; however, cases of uterine rupture leading to fatal complications are rare, particularly in primiparous patients with no history of uterine surgery. Case report: We report the case of a 27-year-old patient, Gravida 1, Para 0 patient who was in her second trimester of pregnancy and had a history of adenomyosis (ultrasound diagnosis) and endometriosis (laparoscopy history). She was admitted to the emergency room due to abdominal pain, with no other associated symptoms, with normal fetal monitoring. Shortly after admission, she experienced hemodynamic deterioration and developed signs of peritoneal irritation, which necessitated an urgent laparotomy. During the procedure, we discovered a fetus in the abdominal cavity and hemoperitoneum. Fetus with respiratory effort and pulse in the umbilical cord weighing 789 grams, required cardiopulmonary resuscitation, with subsequent death. Conclusion: This type of patient should be counseled about the rare but possible risk of uterine rupture, subsequent maternal and perinatal complications such as spontaneous abortion, preeclampsia, small fetus for gestational age, premature birth and cesarean section. In addition, they should be informed about clear warning signs to go to the nearest health center with obstetrics service. The most frequent signs associated with uterine rupture include: sudden onset of intense abdominal pain associated with hypovolemic shock, uterine hypersensitivity and decelerations of the fetal heart rate.
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Adenomiosis y ruptura uterina espontánea en el segundo trimestre de embarazo: reporte de caso Adenomyosis and spontaneous uterine rupture in the second trimester of pregnancy: case report Cómo citar Descargar cita Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0. Mostrar biografía de los autores Introducción: La adenomiosis es una afección ginecológica común sin embargo son raros los casos en que debutan con una ruptura uterina como complicación fatal subsecuente, sobre todo en pacientes primigestantes sin cirugías uterinas previas. Descripción del caso: Exponemos el caso de una paciente de 27 años de edad, G1P0, en el segundo trimestre de embarazo, antecedente de adenomiosis y endometriosis, que ingresa al servicio de urgencias inicialmente con dolor abdominal, sin ningún otro síntoma asociado, con monitoreo fetal normal. Con posterior deterioro hemodinámico e instauración de signos de irritación peritoneal, requiriendo laparotomía de urgencia con hallazgos de feto en cavidad abdominal y hemoperitoneo. Conclusión: Se debe asesorar a este tipo de paciente sobre el riesgo infrecuente pero posible de ruptura uterina, las complicaciones maternas y perinatales subsecuentes como aborto espontáneo, preeclampsia, feto pequeño para la edad gestacional, parto prematuro y cesárea. Además informar sobre signos de alarma claros para acudir al centro de salud con servicio de obstetricia más cercano, dentro de los signos mas frecuentes asociados a ruptura uterina se encuentran: inicio repentino de dolor abdominal intenso asociado a shock hipovolémico, hipersensibilidad uterina y desaceleraciones de la frecuencia cardiaca fetal. Visitas del artículo 267 | Visitas PDF 96 Descargas - 1. Zhan W, Zhu J, Hua X, Ye J, Chen Q, Zhang J. 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