Spontaneous diaphragm rupture during delivery. Case report

2008 
: We report a case of spontaneous diaphragm rupture during delivery in a 42-year-old woman. The patient presented at surgical emergency department with abdominal pains, vomiting and dyspnea, three days after full-term delivery. The X-ray of the chest and computed tomography showed symptoms of a left diaphragmatic rupture. Laparotomy confirmed the diaphragmatic rupture with herniation of portion of the stomach in the left pleural cavity. Spontaneous diaphragmatic rupture during delivery is uncommon and would result from a sudden sharp rise in the intra-abdominal pressure during the second stage of labor, exacerbated by application of external pressure to the uterine fundus or the upper abdomen. Diaphragmatic rupture during labor is a serious but rare complication that requires emergency surgery to prevent visceral perforation and cardiorespiratory failure. To prevent this complication, the delivery conditions should be improved.
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