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Case Reports in Obstetrics and Gynecology
Volume 2017 (2017), Article ID 1404815, 5 pages
https://doi.org/10.1155/2017/1404815
Case Report

Uterine Rupture after Laparoscopic Myomectomy in Two Cases: Real Complication or Malpractice?

1Department of Biomedical and Human Oncological Science (DIMO), 2nd Unit of Obstetrics and Gynaecology, University of Bari, Bari, Italy
2Santa Maria Hospital, GVM Care & Research, Bari, Italy

Correspondence should be addressed to Vittoria Del Vecchio; moc.liamg@dmoihccevled.airottiv

Received 7 September 2017; Revised 16 November 2017; Accepted 28 November 2017; Published 20 December 2017

Academic Editor: Kyousuke Takeuchi

Copyright © 2017 Antonella Vimercati et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We describe two cases of uterine rupture in pregnancy after laparoscopic myomectomy and analyze all the aetiological factors involved in this circumstance according to the recent literature, focusing above all on the surgical procedures and the characteristics of the excised myomas. The two cases of uterine rupture in pregnancy following laparoscopic myomectomy occurred at 36 and 18 weeks of gestation, respectively. Both women had undergone laparoscopic multiple myomectomy and uterine rupture occurred along the isthmic myomectomy scars, despite the fact that compliance with all the recent technical surgical recommendations for the previous laparoscopic multiple myomectomy had been fully observed. In our cases we identified the isthmic localization, size of the excised myomas (≥4 cm), and individual characteristics of the healing process as possible risk factors for “a real complication.” Larger studies and robust case-control analyses are needed to draw reliable conclusions; special care should be paid when performing laparoscopic myomectomy in women planning a later pregnancy.