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 patient with a history of hysteroscopic resection of a uterine septum presented in preterm labor. This was her second pregnancy following the procedure; the first resulted in a term vaginal delivery. This second pregnancy ended with a preterm cesarean delivery. A 3.5 x 3.5-cm fundal rupture was discovered during the cesarean. The metroplasty had been performed with the KTP laser under direct laparoscopic visualization. No surgical complications had occurred.

CONCLUSIONS: Uterine rupture during a pregnancy may occur following hysteroscopic metroplasty, even when no complications occur at surgery and even if a normal pregnancy outcome follows the procedure. Physicians providing care for patients who have had hysteroscopic metroplasty should be aware of the potential for uterine rupture during pregnancy.