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AJP Rep 2016; 06(01): e68-e70
DOI: 10.1055/s-0035-1566243
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Spontaneous Posterior Uterine Rupture in Twin-Twin Transfusion Syndrome

Marcela C. Smid
1   Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina
,
Rebecca Waltner-Toews
2   Department of Obstetrics and Gynecology, University of Pittsburgh, Magee Women's Hospital, Pittsburgh, Pennsylvania
,
William Goodnight
1   Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina
› Author Affiliations
Further Information

Publication History

17 July 2015

10 September 2015

Publication Date:
16 November 2015 (online)

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Abstract

Background The maternal and fetal risks of uterine distension in rapidly progressive twin-twin transfusion syndrome (TTTS) in the setting of prior uterine scar are poorly characterized.

Case We present the case of a 42-year-old woman, G4P1201, at 21 weeks gestation with stage-1 TTTS who developed a spontaneous posterior uterine rupture necessitating emergent laparotomy and delivery of previable fetuses, possibly due to prior uterine scar from a displaced intrauterine device.

Conclusion TTTS may be a risk factor for uterine rupture, including uterine rupture in atypical anatomic locations. Prior unrecognized uterine scars, including perforations, may magnify the risk for atypical uterine rupture in the setting of excessive uterine distension.

Keywords

uterine rupture - twin pregnancy - twin-twin transfusion syndrome
 

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