Spontaneous Uterine Rupture of an Unscarred Uterus before Labour

Abstract

Uterine rupture is a public health problem in developing countries. When it is spontaneous, it occurs most often during labor in a context of scarred uterus. Uterine rupture during pregnancy is a rare situation. The diagnosis is not always obvious and morbidity and maternal and fetal mortality is still high. We report a case of spontaneous uterine rupture during pregnancy at 35 weeks of an unscarred uterus before labour. This is an exceptional case that we observe for the first time in our unit.

Spontaneous mid-trimester rupture of a non-scarred gravid uterus

“…1 Risk factors are multiparity, placental abnormality, uterine anomaly, 2 obstetric maneuvers, injudicious use of oxytocics, external injuries or any previous history of curettage, MRP, myomectomy, 4 In our case no such obvious factor was found except that she had undergone evacuation twice in first trimester of previous pregnancies which might have caused weakening of myometrium. Unscarred uterine rupture usually occurs in lower segment -weakest part.…”

Unscarred uterine rupture - rare entity

“…5 Unscarred uterine rupture is rare, however, risk factors identified are multiparity, injudicious use of oxytocin, obstetric manoeuvres, chronic steroid use, Ehlers Danlos Syndrome, obstructed labour, uterine anomalies and abnormal placentation. [6][7][8][9][10][11][12][13][14] The high parity is recognised as a major risk factor for unscarred uterine rupture and majority of ruptures occur in term pregnancies at the time of labour. There have, however, been few case reports of uterine rupture in non-labouring patients.…”

Spontaneous uterine rupture at 14 weeks gestation during a pregnancy consecutive to an oocyte donation in a woman with Turner's syndrome

“…Spontaneous preterm uterine rupture is very rare [1,2,4,5,[13][14][15][16]. In vitro fertilization (IVF) is known to raise the risk of cornual pregnancy and placenta anomalies.…”

“…It frequently results in lifethreatening maternal haemorrhage and foetal death [1][2][3][4]. Several cases have been reported after embryo transfer, including one patient who died [5,6].…”