Uterine rupture after high-intensity focused ultrasound ablation of adenomyosis: a case report and literature review

Abstract

Aim

High-intensity focused ultrasound (HIFU) is a non-invasive treatment of adenomyosis. Uterine rupture during pregnancy is a rare adverse event after HIFU treatment, because HIFU treatment results in tissue coagulative necrosis.

Methods

We reported a case of uterine rupture in a 34-year-old woman. The woman had HIFU treatment for adenomyosis eight months before unplanned pregnancy. She was closely monitored during the pregnancy and the antenatal course was uneventful. At the gestational age of 38 weeks and 2 days, an emergency lower segment cesarean section was performed because of inexplainable abdominal pain. After delivery of the fetus, a 2 × 2 cm serous membrane rupture was observed in the HIFU treatment area.

Conclusion

Uterine rupture during pregnancy after HIFU is a rare adverse event, however, attention is required during the whole pregnancy in case of unexpected uterine rupture.

Keywords:

• Adenomyosis
• high-intensity focused ultrasound (HIFU)
• unplanned pregnancy
• uterine rupture

Acknowledgements

The authors thank their colleagues in the Pathology Department and Imaging Department for providing the medical pictures. The authors would also like to thank the patient for agreeing to reveal case details for publication.

Consent to participate

This case report was approved by Medical Ethics Committee of West China Second Hospital, Sichuan University (IRB Approval Number: 046). and written informed consent was obtained for publication.

Author contributions

YL and NF managed the case, and wrote the manuscript; XW and YH conducted HIFU treatment; BL conducted cesarean section; XW and YH revised the manuscript. All authors have read and approved the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

All data generated or analyzed during the current study are available from the corresponding author upon reasonable request.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.