A cesarean section scar dehiscence during the first trimester of an intrauterine pregnancy: a rare case report and literature review

TL;DR

A rare case of cesarean section scar dehiscence during early pregnancy is reported, highlighting the importance of timely diagnosis and treatment.

Contribution

This case report adds to the limited literature on early trimester cesarean scar dehiscence and emphasizes diagnostic approaches.

Findings

Cesarean scar dehiscence can occur during the first trimester of an intrauterine pregnancy.

Ultrasound and laparoscopy are effective for diagnosing and managing this rare complication.

Abstract

Uterine rupture is specified as a complete laceration of the uterine wall, including its serosa, leading to a connection between the endometrial and peritoneal chambers. It can occur in any stage of pregnancy and is considered a severe and perhaps fatal complication. A 35-year-old woman at 9 weeks of gestation with a medical history of five prior cesarean sections presented with lower abdominal pain that had lasted for 5 hr. We detected small amounts of free fluid in the Douglas pouch using ultrasound. Subsequently, a laparotomy revealed a cesarean scar dehiscence from a non-cesarean scar pregnancy. Patients who experience a uterine rupture may have vague symptoms, severe abdominal discomfort, abnormal uterine bleeding, and severe hemorrhagic shock, depending on their gestational age. Ultrasound imaging can be used to diagnose this fatal condition in addition to laparoscopy to immediately identify and treat the issue in urgent cases.

Figures