Spontaneous Unscarred Uterine Rupture at 15 Weeks of Pregnancy: A Case Report

Uterine rupture during pregnancy is a serious obstetric complication. The presence of a previous uterine scar is the most important risk factor, whereas rupture in an unscarred uterus is a rare event. A 34-year-old woman, gravida 3 para 1, presented with sudden acute hypogastric pain at 15 weeks of...

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Bibliographic Details
Published in:The Ochsner journal 2016, Vol.16 (4), p.545-547
Main Authors: Mannini, Luca, Sorbi, Flavia, Ghizzoni, Viola, Masini, Giulia, Fambrini, Massimiliano, Noci, Ivo
Format: Article
Language:English
Subjects:
Abdomen
Age
Blood
Case reports
Case Reports and Clinical Observations
Defects
Health risk assessment
Hemoglobin
Laparoscopy
Obstetrics
Pain
Placenta
Pregnancy
Pregnancy complications
Surgery
Systematic review
Ultrasonic imaging
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Summary:Uterine rupture during pregnancy is a serious obstetric complication. The presence of a previous uterine scar is the most important risk factor, whereas rupture in an unscarred uterus is a rare event. A 34-year-old woman, gravida 3 para 1, presented with sudden acute hypogastric pain at 15 weeks of gestation. The patient had no history of cesarean delivery. Ultrasound scans showed an empty endometrial cavity continuing directly into the amniotic sac that developed mainly outside the uterus. Because of the ultrasound findings and the patient's progressive anemia, a laparoscopy was performed that revealed a massive hemoperitoneum caused by the rupture of the uterine fundus with exteriorization of most of the amniotic sac. Laparoscopy was converted to laparotomy, the pregnancy was removed, and the uterine disruption was repaired. Early diagnosis and prompt treatment of uterine rupture may significantly improve prognosis. This severe obstetric complication should be considered even in early gestational age pregnancies and in the absence of known risk factors.
ISSN:1524-5012