Posterior uterine rupture – A devil with many faces

Abstract

Uterine rupture in an unscarred uterus is a rare occurrence. A 25 years old, multigravida woman with an unscarred uterus who was induced with misoprostol at a primary health center and referred to our facility with provisional diagnosis of placental abruption with fetal distress. We diagnosed her to have posterior uterine wall rupture with dead fetus. Active management with emergency laparotomy and obstetric hysterectomy led to complete recovery of the mother with uneventful 3 month follow up. The report highlights the need for judicious induction, considering uterine rupture as differential diagnosis even in an unscarred uterus in case of non progress of labor, and urgent referral to higher centre for timely management.

Early Labor Posterior Uterine Wall Rupture in a Primigravid Mother with Successful Repair and Live Birth: A Case Report

“…1,2 Primary uterine rupture occurs in an intact or unscarred uterus, whereas secondary uterine rupture is related to a previous myometrial incision, damage, or malformation. 3 Unscarred pregnancy uterine rupture is an uncommon occurrence that is thought to take place in 1/5700 to 1/20,000 pregnancies. 1,4 The anterior lower portion of the uterus is where the majority of ruptures in unscarred uteruses take place; posterior wall ruptures are scarce.…”