Uterine Rupture With Placenta Percreta Following Multiple Adenomyomectomies

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2023 Mar 16

PMID 36923199

Authors

Manabu Ogoyama

Kazuki Yamamoto

Hirotada Suzuki

Hironori Takahashi

Hiroyuki Fujiwara

Affiliations

Soon will be listed here.

Abstract

Pregnancy following adenomyomectomy is challenging because uterine rupture or placenta accreta spectrum (PAS) is more likely to occur; however, optimal management has not yet been established. We herein present a case of uterine rupture with placenta percreta in a pregnant woman who underwent adenomyomectomy twice before pregnancy. Magnetic resonance imaging (MRI) was performed in the second trimester and imminent uterine rupture concomitant with PAS was suspected. The patient was immediately admitted to hospital for careful management. Although failed tocolysis forced delivery at 29 weeks of gestation, managed hospitalization allowed cesarean hysterectomy to be performed uneventfully. Extensive PAS was proven pathologically in the removed uterus. Pregnancies following multiple adenomyomectomies are considered to be high-risk. Therefore, a sufficient explanation of the risks associated with future pregnancies is needed, particularly following second adenomyomectomy.

Citing Articles

Hysteroscopic Endometrial Defect Following Adenomyomectomy and Incidence of Placenta Accreta Spectrum and Uterine Rupture Complications for Subsequent Pregnancy.

Ichinose M, Iriyama T, Hiraike O, Sayama S, Hashimoto A, Suzuki K Reprod Sci. 2025; 32(2):467-473.

PMID: 39762486 PMC: 11825535. DOI: 10.1007/s43032-024-01758-7.

Possible risks and benefits of adenomyomectomy on pregnancy outcomes: a retrospective analysis.

Sayama S, Iriyama T, Hashimoto A, Suzuki K, Ariyoshi Y, Yano E AJOG Glob Rep. 2023; 3(4):100265.

PMID: 37771974 PMC: 10523262. DOI: 10.1016/j.xagr.2023.100265.

References

Morimatsu Y, Matsubara S, Higashiyama N, Kuwata T, Ohkuchi A, Izumi A . Uterine rupture during pregnancy soon after a laparoscopic adenomyomectomy. Reprod Med Biol. 2018; 6(3):175-177. PMC: 5904602. DOI: 10.1111/j.1447-0578.2007.00182.x. View

Matsuzaki S, Yoshino K, Tomimatsu T, Takiuchi T, Kumasawa K, Kimura T . Placenta accreta following laparoscopic adenomyomectomy: a case report. Clin Exp Obstet Gynecol. 2018; 43(5):763-765. View

Nagao Y, Osato K, Kubo M, Kawamura T, Ikeda T, Yamawaki T . Spontaneous uterine rupture in the 35th week of gestation after laparoscopic adenomyomectomy. Int Med Case Rep J. 2016; 9:1-4. PMC: 4690644. DOI: 10.2147/IMCRJ.S94363. View

Otsubo Y, Nishida M, Arai Y, Ichikawa R, Taneichi A, Sakanaka M . Association of uterine wall thickness with pregnancy outcome following uterine-sparing surgery for diffuse uterine adenomyosis. Aust N Z J Obstet Gynaecol. 2015; 56(1):88-91. DOI: 10.1111/ajo.12419. View

Makino S, Takeda S, Kondoh E, Kawai K, Takeda J, Matsubara S . National survey of uterine rupture in Japan: Annual report of Perinatology Committee, Japan Society of Obstetrics and Gynecology, 2018. J Obstet Gynaecol Res. 2019; 45(4):763-765. DOI: 10.1111/jog.13924. View

Yazawa H, Endo S, Hayashi S, Suzuki S, Ito A, Fujimori K . Spontaneous uterine rupture in the 33rd week of IVF pregnancy after laparoscopically assisted enucleation of uterine adenomatoid tumor. J Obstet Gynaecol Res. 2011; 37(5):452-7. DOI: 10.1111/j.1447-0756.2010.01361.x. View

Kwack J, Jeon S, Kim K, Lee S, Kwon Y . Monochorionic twin delivery after conservative surgical treatment of a patient with severe diffuse uterine adenomyosis without uterine rupture. Obstet Gynecol Sci. 2016; 59(4):311-5. PMC: 4958678. DOI: 10.5468/ogs.2016.59.4.311. View

Huang X, Huang Q, Chen S, Zhang J, Lin K, Zhang X . Efficacy of laparoscopic adenomyomectomy using double-flap method for diffuse uterine adenomyosis. BMC Womens Health. 2015; 15:24. PMC: 4359498. DOI: 10.1186/s12905-015-0182-5. View

Kwack J, Lee S, Kwon Y . Pregnancy and delivery outcomes in the women who have received adenomyomectomy: Performed by a single surgeon by a uniform surgical technique. Taiwan J Obstet Gynecol. 2021; 60(1):99-102. DOI: 10.1016/j.tjog.2020.11.015. View

10.

Sugiyama M, Takahashi H, Baba Y, Taneichi A, Suzuki H, Usui R . Perinatal outcome of pregnancy after adenomyomectomy: summary of 10 cases with a brief literature review. J Matern Fetal Neonatal Med. 2019; 33(24):4145-4149. DOI: 10.1080/14767058.2019.1597845. View

11.

Jin T, Kyozuka H, Fujimori M, Nomura S, Hakozaki Y, Suzuki D . Unexpected placenta accreta spectrum after the use of assisted reproductive technology in women with adenomyomectomy. Fukushima J Med Sci. 2021; 67(1):45-48. PMC: 8075559. DOI: 10.5387/fms.2021-02. View

12.

Wada S, Kudo M, Minakami H . Spontaneous uterine rupture of a twin pregnancy after a laparoscopic adenomyomectomy: a case report. J Minim Invasive Gynecol. 2006; 13(2):166-8. DOI: 10.1016/j.jmig.2005.12.002. View

13.

Dim C, Agu P, Dim N, Ikeme A . Adenomyosis and uterine rupture during labour in a primigravida: an unusual obstetric emergency in Nigeria. Trop Doct. 2009; 39(4):250-1. DOI: 10.1258/td.2009.080359. View