Abstract
Background
Uterine rupture in pregnancy is associated with severe maternal and fetal complications.
Although it is a rare event, uterine rupture has been associated with certain risk
factors. Glucocorticoids are known to weaken skeletal muscles; however, there have
been no studies on the effects of chronic steroid use on the uterine myometrium.
Case
We present the case of a 40-year-old multigravid woman who experienced a posterior
uterine wall rupture on an unscarred uterus. She was on chronic glucocorticoids for
the treatment of psoriatic arthritis. We hypothesize that the catabolic effects of
glucocorticoids on skeletal muscles also weakened the uterine myometrium, leading
to a higher risk of uterine rupture.
Conclusion
Uterine rupture may be associated with chronic use of corticosteroids. Identifying
the different risk factors for uterine rupture can lead to more prompt diagnosis and
management of uterine rupture, resulting in better maternal and fetal outcomes.
Résumé
Contexte
La rupture utérine pendant la grossesse s'accompagne de graves complications maternelles
et fœtales. Bien qu'il s'agisse d'un événement rare, la rupture utérine est associée
à certains facteurs de risque. Il est connu que les glucocorticoïdes affaiblissent
les muscles squelettiques; cependant, aucune étude ne s'est penchée sur les effets
de l'utilisation chronique de stéroïdes sur le myomètre.
Cas
Nous présentons le cas d'une femme multigeste de 40 ans qui a subi une rupture de
la paroi utérine postérieure sur un utérus non cicatriciel. Elle prenait des glucocorticoïdes
sur une base chronique pour le traitement de l'arthrite psoriasique. Nous supposons
que les effets cataboliques des glucocorticoïdes sur les muscles squelettiques ont
aussi affaibli le myomètre, ce qui a augmenté le risque de rupture utérine.
Conclusion
La rupture utérine peut être associée à une utilisation chronique de corticostéroïdes.
Le fait de déterminer les différents facteurs de risque de rupture utérine peut favoriser
le diagnostic et la prise en charge précoces de la rupture utérine, ce qui améliore
les issues maternelles et fœtales.
Keywords
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REFERENCES
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Article info
Publication history
Published online: April 26, 2020
Footnotes
Disclosures: The authors declare they have nothing to disclose.
All authors have indicated that they meet the journal's requirements for authorship.
Identification
Copyright
© 2020 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
