Prolapsed intestine through the vulva as a sign of rupture in unscarred uterus: Report of 2 cases.
- Author:
Gheany G GERALES
;
Ivy PRINCIPE
;
Joan T CORPUZ
;
Nephtali M GORGONIO
- Publication Type:Case report
- Keywords:
ProlapseUnscarred Uterus
- MeSH:
Human;
Female;
Adult;
X
- From:
Philippine Journal of Obstetrics and Gynecology
2010;34(1):23-30
- CountryPhilippines
-
Abstract:
Presented herein are 2 cases of rupture in unscarred uterus involving the posterior lower uterine segment. Both cases had history of fundal pressure prior to the delivery at home by a traditional birth attendant and a midwife. Case 1 was admitted with an intestine protruding through the vulva. Case 2 was admitted for undelivered placenta. After manual extraction of the placenta and exploration of the uterine cavity, the intestine prolapsed through the vulva. Both cases subsequently underwent total abdominal hysterectomy and intestinal resection with end to end anastomosis. Rupture of unscarred uterus during pregnancy is a rare obstetric complication. Rarer still is its occurrence at the posterior lower uterine segment. Forceful fundal pressure done in an attempt to deliver the baby vaginally can cause traumatic rupture of the uterus. Caution should be exercised in using this maneuver as it remains to be controversial in the management of second stage of labor. Clinical patterns of uterine rupture vary considerably but one should be aware of its usual presenting signs and symptoms. Prolapse of the intestine through the vulva is considered a rare sign of uterine rupture. This is a report of two isolated and extremely rare cases. These cases should remind us to retrain health care providers, particularly the traditional birth attendants and midwives, to avoid repeating this type of incidents.
