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A 30-year-old primigravida experienced spontaneous uterine rupture at 18 weeks of gestation. The etiology for the rupture was an extensive, heavily decidualized adenomyosis. Although adenomyosis is relatively common, complications are rare.

Between 1992 and 1993 surgery conserving the organ was undertaken in 215 patients with uterine myomas. Only myomas of more than 2 cm in diameter were included. It was possible to conserve the organ in 207 cases (90%). Myomectomy by pelviscopy was performed in 131 cases. The procedure was successful in 117 cases (89%), secondary laparotomy had to be done in 14 of these patients. On average the myomas removed by pelviscopy measured 5.2 cm in diameter. The S.E.M.M. (Serrated Edged Macro Morcellator) was used in the procedure. It did not take long to morecellate even larger myomas (the largest one removed by pelviscopy weighed 418 g) and to remove them by means of a 15 mm-trocar. An average of 2 myomas were removed per patient (r: 1-5). The mean Hb drop amounted to 1.5 g%. Repeat pelviscopy had to be done in one patient because of a secondary haemorrhage, a laparotomy and hysterectomy for subilius had to be performed in one case on the 3rd postoperative day. An intestinal loop has adhered to the uterine wound dehiscence. No other complications were observed after pelviscopic myomectomy. A 41-year-old patient wanting children suffered a late complication, namely a ruptured uterus in the 28 w of pregnancy. It is therefore imperative to inform patients who are still in the reproductive phase about the possibility of an uterus rupture after pelviscopic myomectomy.

The placenta percreta is a rare event in pregnancy. A case of spontaneous rupture of the uterus in the 22nd week caused by placenta percreta (verified by histological examination) is described. Causal facts and therapeutic aspects are discussed.

A report is made on a pregnancy of a 33-year old II-gravida/I-para patient, terminating with the rupture of the uterus bicornis unicollis in the 18th week of pregnancy. The cause of this rupture was believed to be pathological disturbance of the attachment of the placenta. The early detection of uterine anomalies with ultrasonic investigation, reviewing the literature, is discussed.

Reference is made to a report on intramural pregnancy, the twelfth case so far described in accessible literature, and the authors' own views on the possible origin of this extremely rare location of pregnancy are added to other assumptions so far made on the pathogenesis. The hypothetical proposition made by the author's is based on the assumption of transperitoneal penetration of the uterine wall by the spermovium via a focus of endometriosis. Described are case histories, symptoms, tentative diagnoses, and surgical approach in the cases so far observed.

Reported in this paper is a case of double traumatic rupture in the fundus of the uterus. The patient concerned was in the 36th week of pregnancy, when she fell from a height of three metres. The child was delivered dead from the peritoneal cavity by abdominal section. Supracervical uterus amputation was performed on the woman who survived.

The diagnosis of a via falsa abnormality of uterus duplex unicollis by ultrasound is reported in a case of unclear gynecological examination finding.

Pyelonephritis and urinary calculi are the most frequent urological complications during pregnancy. They are followed by injuries of the urinary system during birth or in connection with multiple traumas in traffic accidents. Kidney transplantation or permanent urinary diversion (Ileum- or Colon-Conduit) are not an absolute obstacle for pregnancies when closely followed. Problematic for mother and child is the coincidence of pregnancy and malignant tumours. In that case good cooperation among the different specialities is necessary. This study provides a concept for the diagnostic and therapeutic procedures. Knowledge of adequate methods of examination and modern techniques and a timely treatment meeting the demands of the situation prevent complications and sequelae of the pregnancy.

The case of a woman patient of 30 years of age is reported in whom spontaneous rupture of the uterus occurred in the 22nd week of pregnancy due to a uterus bicornis with placenta increta. The very rare disease pattern, which is often associated with many complications, of a disturbance of implantation of the placenta, often demands immediate surgery and can mostly be diagnosed only retrospectively. Hence, an early recognition method would be desirable. Basing on the literature, the significant rôle played by sonographic diagnosis in this connection is pointed out.

There are 16 ruptures of the uterus in a total of 28,391 deliveries, adequate a frequency of 0.59% or one rupture in 1774 cases. Whereas the fetal mortality is 43.7%, the maternal one amounts to 0%. Previous cesarean sections could be observed in 56.2%. The problems of ruptures of cicatrical uterus without symptoms and the complications will be referred to.

We report a rare case of spontaneous rupture of the uterus in a 20 weeks pregnancy, which was treated surgically with a good outcome for the mother. The microscopic appearance of the uterus and the histologic examination of the rupture sites are compatible with invasive placenta with signs of acute of chronic infection and areas of syncytial infection of the uterus.