2020, Number 06
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Ginecol Obstet Mex 2020; 88 (06)
Didelphys uterus as a cause of spontaneous uterine rupture. A case report
Conde-Gutiérrez YS, Cruz-López N, Jiménez-Ibáñez LC
Language: Spanish
References: 12
Page: 407-411
PDF size: 285.01 Kb.
ABSTRACT
Background: Mullerian malformations are a group of congenital pathologies resulting
from from an inadequate development of the Mullerian ducts during embryogenesis.
The 25% of women with mullerian malformations have obstetric problems. Spontaneous
rupture of the didelphys uterus during pregnancy is a rare and difficult- to- diagnose
accident. The fundamental importance of the study of these malformations lies in the
various diagnostic and therapeutic possibilities employed, in addition to the improvement
in the reproductive prognosis of the patients.
Clinical case: 27-year-old patient, who starts suddenly with severe abdominal
pain. She arrives at the emergency department with blood pressure of 90/50 mmHg,
pale-mucous paleness, coldness, hypotension and hypothermia, painful abdomen,
non-delimitable uterine fundus, with data of peritoneal irritation; closed cervix, without
transvaginal bleeding. On ultrasound: single extrauterine fetus, with absence of
cardiac activity, 21.2 weeks, presence of free fluid in abdominal cavity. An exploratory
laparotomy is performed by finding a didelphys uterus with uterine rupture and a Strassman
metroplasty is performed.
Conclusión: Despite the low frequency of the clinical case presented, we believe
that it should be considered in the differential diagnosis of pregnant women with
abdominal pain in the second trimester. Likewise, we consider it important to make
it known to contribute to early approach and treatment, avoiding complications such
as uterine rupture.
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