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Ginecología y obstetricia de México
versión impresa ISSN 0300-9041
Resumen
CONDE-GUTIERREZ, Yazmín del Socorro; CRUZ-LOPEZ, Noemí y JIMENEZ-IBANEZ, Linda Carmín. Didelphys uterus as a cause of spontaneous uterine rupture. A case report. Ginecol. obstet. Méx. [online]. 2020, vol.88, n.6, pp.407-411. Epub 20-Sep-2021. ISSN 0300-9041. https://doi.org/10.24245/gom.v88i6.3705.
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.
CONCLUSION:
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.
Palabras llave : Müllerian ducts; Malformations; Abdominal Pain; Blood Pressure; Hypotension; Hypothermia; Abdominal Cavity; Uterine Rupture.