{
    "abstract": "Uterine rupture during pregnancy is a serious obstetric complication accompanied by a high incidence of maternal morbidity and mortality, and the presence of uterine scars is the main risk factor. In the present case, uterine rupture occurred in an unscarred uterus in a nonlaboring primigravida woman with adenomyosis and twin pregnancy in the third trimester.\nIn this case, the patient suspected to have a history of endometriosis have got twin pregnancies following intracytoplasmic sperm injection, and complained of recurrent lower abdominal pain from 16 weeks to 29 weeks of gestation.\nAfter exploratory laparotomy, the patient was diagnosed with uterine rupture and adenomyosis.\nThe patient was first administered expectant treatment such as antibiotics, tocolytics, and fluid replacement therapy. Symptoms then appeared repeatedly and worsened, followed by eventual peritoneal irritation, and exploratory laparotomy was performed.\nTwo live female fetuses were extracted by cesarean section, and the uterine laceration was repaired. The mother recovered without any postoperative complications, and the babies were discharged after receiving one month of prematurity care without any postnatal complications.\nAdenomyosis and the conception of twins may lead to uterine rupture. For pregnant women with a history of adenomyosis with multiple gestations, close monitoring for signs of uterine rupture is necessary. Single-embryo transfer and multifetal pregnancy reduction should be recommended for infertile patients with adenomyosis.",
    "authors": [
        {
            "affiliation": "Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University.\nNHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University.\nKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China.",
            "firstname": "Xuqing",
            "initials": "X",
            "lastname": "Li"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University.\nNHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University.\nKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China.",
            "firstname": "Caihua",
            "initials": "C",
            "lastname": "Li"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University.\nAnhui Province Key Laboratory of Reproductive Health and Genetics.\nBiopreservation and Artificial Organs, Anhui Provincial Engineering Research Center, Anhui Medical University, Hefei, China.",
            "firstname": "Meiguo",
            "initials": "M",
            "lastname": "Sun"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University.\nAnhui Province Key Laboratory of Reproductive Health and Genetics.\nBiopreservation and Artificial Organs, Anhui Provincial Engineering Research Center, Anhui Medical University, Hefei, China.",
            "firstname": "Hongyan",
            "initials": "H",
            "lastname": "Li"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University.\nAnhui Province Key Laboratory of Reproductive Health and Genetics.\nBiopreservation and Artificial Organs, Anhui Provincial Engineering Research Center, Anhui Medical University, Hefei, China.",
            "firstname": "Yunxia",
            "initials": "Y",
            "lastname": "Cao"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University.\nNHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University.\nKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China.",
            "firstname": "Zhaolian",
            "initials": "Z",
            "lastname": "Wei"
        }
    ],
    "conclusions": "Adenomyosis and the conception of twins may lead to uterine rupture. For pregnant women with a history of adenomyosis with multiple gestations, close monitoring for signs of uterine rupture is necessary. Single-embryo transfer and multifetal pregnancy reduction should be recommended for infertile patients with adenomyosis.",
    "copyrights": "Copyright \u00a9 2021 the Author(s). Published by Wolters Kluwer Health, Inc.",
    "doi": "10.1097/MD.0000000000024048",
    "journal": "Medicine",
    "keywords": [],
    "methods": null,
    "publication_date": "2021-02-07",
    "pubmed_id": "33546004\n26026917\n27651577\n3712359\n23151226\n9130884\n14639160\n16101600\n17425811\n18684451\n18439512\n19623852\n8001754\n22035954\n8588451\n26753492\n18798421\n28840046\n28666503\n23234036\n16527723\n15008396\n27459146\n25099561\n2304727\n29728141\n14499715\n12593906",
    "results": null,
    "title": "Spontaneous unscarred uterine rupture in a twin pregnancy complicated by adenomyosis: A case report.",
    "xml": "<Element 'PubmedArticle' at 0x788502532200>"
}