Relationship between prelabour uterine rupture and previous placenta previa diagnosis: case reports and review of literature

Background. The number of Caesarean sections is growing worldwide, in- tensifying the risk of complications in subsequent pregnancies and leading to increased maternal and fetal morbidity and mortality. In particular, the lit- erature shows a higher risk of uterine rupture in subsequent pregnancy with trial of labor after caesarean section. Furthermore, there are few data about pre-labor uterine rupture in scarred uteri. Objective. Since the key factor for management is timing, the aim of this cas- es report was to describe the accuracy of prenatal ultrasound of scars in the early determining of pre-labor UR risk in two cases with a previous Caesare- an sections during their subsequent pregnancy. Case presentation. We reported two cases of uterine rupture occurring out- side of labour in patients with a history of caesarean section due to placenta previa. In the current cases was reported how a higher hysterotomy, com- bined with some risk factors, could increase the prevalence of UR in the sub- sequent pregnancy. Conclusions. In these cases, a higher uterine incision due to placenta previa or isthmic myoma seems to be correlated with a major risk of UR. Therefore, al- though in a limit experience, we report that the periconceptional prenatal ultra- sound examination of previous cesarian section level could represented a use- ful predictive factor of pre-labor uterine rupture in subsequent pregnancies.