UTERINE RUPTURE DURING PREGNANCY IN A PATIENT WITH A HISTORY OF HYSTEROSCOPIC METROPLASTY

Background: Uterine septa may be responsible for spontaneous abortion. Hysteroscopic metroplasty may improve pregnancy outcome. Case: A pati ent with a history of hysteroscopic resection of a uterine septum pres ented in preterm labor. This was her second pregnancy following the pr ocedure; the first resulted in a term vaginal delivery. This second pr egnancy ended with a preterm cesarean delivery. A 3.5 x 3.5-cm fundal rupture was discovered during the cesarean. The metroplasty had been p erformed with the KTP laser under direct laparoscopic visualization. N o surgical complications had occurred. Conclusion: Uterine rupture dur ing a pregnancy may occur following hysteroscopic metroplasty, even wh en no complications occur at surgery and even if a normal pregnancy ou tcome follows the procedure. Physicians providing care for patients wh o have had hysteroscopic metroplasty should be aware of the potential for uterine rupture during pregnancy.