Natural conception and successful delivery after laparoscopic uterine anastomosis for traumatic cervical separation: a case report.

BACKGROUND: Traumatic separation of the cervix from the body of the uterus is exceedingly rare, particularly as a complication of pelvic fractures. This condition often poses significant diagnostic and therapeutic challenges, especially in patients with primary infertility and endometriosis. Fertility preservation in such cases is seldom reported, and effective surgical management remains clinically controversial.

CASE PRESENTATION: We report the case of a 28-year-old East Asian Chinese woman with a history of severe pelvic trauma that resulted in complete separation of the cervix from the body of the uterus. She presented with secondary amenorrhea and cyclical abdominal pain. Laparoscopic anastomosis between the body of the uterus and cervix was performed with the aim of restoring reproductive function. Postoperatively, the patient resumed normal menstruation and subsequently conceived naturally, with full knowledge of the potential risks of pregnancy explained by doctor. During the pregnancy, implantation of the gestational sac occurred at the anastomosis site, and the patient developed placenta percreta, which gradually worsened from the second trimester. Through the implementation of a systematic, multidisciplinary management strategy involving both gynecology and obstetrics teams, a satisfactory maternal and fetal outcome was achieved with delivery at 30 weeks of gestation.

CONCLUSION: This case demonstrates the feasibility and clinical significance of laparoscopic uterine-cervical anastomosis in restoring fertility and supporting pregnancy after traumatic cervical separation. The successful multidisciplinary management of placenta percreta originating from the anastomosis site further highlights the importance of coordinated care in managing rare and complex obstetric cases.