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Federación Mexicana de Ginecología y Obstetricia, A.C.

2019, Number 03

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Ginecol Obstet Mex 2019; 87 (03)

Vaginal birth through posterior uterine breaking in Arabin pessary carrier patient

Serrano-Diana C, Amezcua-Recover AN, Gil-Martínez Acacio L, Roque-Fernández MÁ, González-Mirasol E

Language: Spanish
References: 9
Page: 208-212
PDF size: 241.53 Kb.


ABSTRACT

Background: Preterm delivery is an important cause of maternal-fetal morbimortality. The cervical pessary is an effective method to prevent preterm birth in patients with short cervix.
Clinic case: A 38-year-old patient, 34.3 weeks pregnant, attended the clinic due to hidrhorea and abdominal pain. Among his gynecological and obstetric history he referred to the placement of Arabin pessary from week 20 of pregnancy, by diagnosis of short cervix (14 mm). The medical examination revealed: Cervix closed and formed, with a 2 cm tear in the posterior uterine side, indicating an emergency caesarean section. Five minutes later, there was a significant increase in abdominal pain, with the fetal head being seen in the IV plane of Hodge. Therefore, it was decided to assist with delivery in the surgical area. A newborn male, 2045 g, was obtained with Apgar 9 / 10, who entered the neonatology area. Subsequently, the isthmic-cervical tear, of approximately 7 cm, with a medial ascending extension of 4 cm, which was sutured without incident, was confirmed. The immediate and delayed puerperium proceeded normally. One year after the obstetric event, the patient is in excellent health.
Conclusions: Uterine rupture associated to pessary is an extremely rare complication. To date there is no optimal treatment scheme. A conservative behavior is preferred, especially if there is a reproductive desire, and each case is individualized.


REFERENCES

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