Die Uterusruptur: Eine seltene, jedoch schwere Komplikation der Konisation*

The rupture of a gravid uterus is a serious threat to the mother's life and her fetus, associated with high maternal and perinatal mortality and morbidity and the loss of future fertility as hysterectomy is inevitable in many cases. A case of a patient with a uterine rupture caused by a cone biopsy is described. Intrapartally no typical signs of a uterine rupture were observed with the exception of a vaginal bleeding and painful contractions. Because there was a fetal bradycardia, a cesarean section was conducted. A complete rupture of the cervical, vaginal and uterine wall on the left side and an incomplete rupture of the cervical and uterine wall on the right side with large hematomas in the left and right parametrium were seen at surgery. A subtotal hysterectomy was inevitable after cesarean section. On the 18th postoperative day the patient and her healthy baby were discharged from hospital. To prevent this obstetric hazard we conclude that it is necessary to conduct a correct supervision of the pregnant women and to conduct a correct supervision of delivery in all patients with a history of cone biopsy. Midwives' and physicians' training and hospital deliveries are other important factors in prevention. Furthermore a well estimated use of cone biopsy to clarify critical cervical findings in younger women is necessary.