Tropical Doctor > Volume 39, Number 4 > Pp. 250-251

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Case Series and Case Reports

Adenomyosis and uterine rupture during labour in a primigravida: an unusual obstetric emergency in Nigeria

Cyril C Dim FWACS   ^*    Polycarp U Agu FWACS   ^*   Ngozi R Dim MBBS      Arthur C Ikeme FRCOG FWACS   ^*

^* Department of Obstetrics; Department of Gynaecology and Radiation Medicine, University of Nigeria Teaching Hospital (UNTH), PMB 01129, Enugu 40001, Nigeria

Correspondence to: Dr Cyril C Dim, Department of Obstetrics, University of Nigeria Teaching Hospital (UNTH), PMB 01129, Enugu 40001, Nigeria Email: dyme72{at}yahoo.com

The primigravid uterus is believed to be immune to rupture during labour. This may not be true for those who have had prior adenomyomectomy, hence this report. The patient was a 28-year-old nullipara who became pregnant 11 months after an adenomyomectomy. Twelve hours after vaginal delivery at term, she developed haemoperitoneum of unclear cause. Emergency laparotomy and subsequent histology showed a fundal complete uterine rupture through the adenomyomectomy site, which was repaired. It is concluded that adenomyomectomy predisposes a pregnant uterus to rupture during labour. Therefore, such women should be offered elective caesarean delivery at term.

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