Intrapartum uterine rupture in a primiparous patient previously treated for invasive mole.

BACKGROUND

Intrapartum rupture of the uterus in a primiparous patient is an exceedingly rare event. This case report describes uterine rupture in a woman with previous invasive hydatidiform mole.

CASE: A 27-year-old primiparous woman with a history of gestational trophoblastic neoplasia treated successfully with chemotherapy experienced intrapartum uterine rupture with subsequent neonatal death. Magnetic resonance imaging of the uterus had shown evidence of myometrial invasion by the mole. Weakening of the uterine wall secondary to myometrial destruction is believed to have caused the uterine rupture.

CONCLUSION

Many women will attempt to conceive following treatment for gestational trophoblastic neoplasia. It is important to determine whether there is any local invasion of the myometrium, as this can affect intrapartum management in subsequent pregnancies.