First trimester spontaneous rupture of an unscarred uterus in a multiparous woman: a case report

Ahmed M. Abbas, Department of Obstetrics and Gynecology, Faculty of Medicine; Assiut University, Assiut, Egypt
Amera M. Sheha, Faculty of Medicine; Assiut University, Assiut, Egypt
Mohamed Abdallah, Department of Obstetrics and Gynecology, Faculty of Medicine; Assiut University, Assiut, Egypt
Sara Abdullah, Faculty of Medicine; Assiut University, Assiut, Egypt
Mohamed Bahaa, Faculty of Medicine; Assiut University, Assiut, Egypt

Abstract

The rupture of an unscarred uterine is a rare life-threatening event that usually occurs late in pregnancy or during labor. Spontaneous uterine rupture, as in our case, is extremely uncommon and rarely diagnosed before laparotomy. Herein, we present a case of spontaneous uterine rupture in a 32 year old multiparous woman with no previous uterine surgery. The patient presented with acute abdomen at 11 weeks of gestation. Preoperative diagnosis based on clinical and ultra-sonographic findings was ruptured ectopic pregnancy. However, emergency laparotomy showed uterine rupture with extrusion of a dead fetus within intact amniotic sac in the abdomen. The defect was repaired in layers and the patient was discharged in a good condition after five days of hospital stay. Multiparity is a risk factor for spontaneous uterine rupture even in the first trimester. It should be kept in mind in any pregnant multiparous woman presenting with acute abdomen and shock. The absence of vaginal spotting and lack of history of uterine surgery give a false sense of security.

 

URL

http://ir.uiowa.edu/pog_in_press/59