Uterine rupture in twin pregnancy complicated with herniation of amniotic sac and umbilical cord: a case report

Abstract

Uterine rupture in twin pregnancy complicated with herniation of amniotic sac and umbilical cord: a case report Erqiu Du 1 , Yongmei Li 2 , Li Shang 2 , Yongli Chen 2 , Xia Gao 2 , Xueying Duan 2 1Department of Obstetrics and Gynecology, Taizhou General Hospital, (Taizhou University Hospital), Taizhou, Zhejiang 2Department of Obstetrics and Gynecology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei (China) Summary The typical symptom of complete uterine rupture is continuous pain in lower abdomen. The prognosis of a complete uterine rupture is poor. However, twin pregnancy with asymptomatic uterine rupture leading to two live fetuses are rare. The authors report a case of a 41-year-old asymptomatic woman with twin pregnancy (gravida 4, para 1) who presented with a large herniation of the amniotic sac through the left uterine horn that was detected by ultrasonography at 26 +5 weeks of gestation. After comprehensive counseling and under close observation, the patient chose to proceed with her pregnancy and extend the pregnancy to 28 +5 weeks gestation. Scarred uterine is the most common risk factor of uterine rupture during pregnancy. The typical symptom of complete uterine rupture is continuous pain in lower abdomen. However, there is no characteristic presentation in uterine rupture. Ultrasound and MRI are all important supplementary means to diagnose the uterine rupture. Therefore, obstetrician should pay more attention to the patients who have the related history or are suspected uterine rupture during pregnancy. Key words: Uterine rupture; Twin pregnancies; Obstetrics; Pregnancy.