Spontaneous uterine rupture of an unscarred uterus revealed by a subocclusive syndrome: A case report and review of the literature

Abstract

Spontaneous uterine rupture of an unscarred uterus is a complication that has dramatic results for both mother and fetus. The clinical presentation commonly comprises abdominal pain and metrorrhagia however we report a case of spontaneous uterine rupture revealed by a subocclusive syndrome. We report a case of a young woman who came to the ER with 3 days of progressive abdominal pain and subocclusive syndrome. The current pregnancy was estimated at 32 weeks of amenorrhea and the patient was hemodynamically stable. An obstetric ultrasound was performed showing a progressive monofoetal pregnancy and moderate peritoneal effusion. In view of the presence of effusion on ultrasound and the subocclusive syndrome, an abdominal and pelvic CT scan with contrast was carried out, showing a fundal uterine rupture defect with contrast media extravasation and intraperitoneal hemoperitoneum. The patient was immediately transferred to the operating room for a caesarean section. Although CT scans use radiation, their contribution was essential to avoid maternal death.

Antepartal Spontaneous Complete Fundal Non-Scarred Uterine Rupture in Twin Pregnancy

“…Spontaneous, antepartal (pre-labor) silent fundal rupture of the non-scarred uterus in the third trimester is an extremely rare and usually catastrophic obstetric emergency, associated with high maternal and fetal mortality 1 . Only a few cases with good outcome have been reported, and a case similar to ours was recently published by Sun et al 2 in a pregnant woman after in vitro fertilization secondary to bilateral salpingectomy, in which it was possible to preserve the uterus 2 .…”