An Unusual Case of Ruptured Uterus Associated With Placenta Abruption: Case Report

Abstract

Association of abruption of placenta and ruptured uterus is extremely rare, there were only a few cases described in the past. A 24 year-old woman, G2P1 L0 with history of previous Cesarean Section for obstructed labour and now at 7 months of pregnancy, presented with features of acute abdomen with severe anemia. Her pulse rate was 136 per minute, temperature 36.1o C., respirations 28 per minute, blood pressure 96/50 mm. of Hg. Height of uterus 28 weeks, had tenderness and rigidity over the upper abdomen. She was suspected to have Haemoperitoneum due to ruptured uterus, and laparotomy was performed under IV Ketamine as provision of general anaesthesia was unavailable. Intra-operative findings were Haemoperitoneum, recovery of huge amount of clots from peritoneal cavity, Posterior fundal rupture with intact amniotic sac. A fresh stillborn fetus was delivered from the intact amniotic cavity with clear liquor through the rupture site followed by repair of the rent. She received blood transfusion and recovered without any complication. Laparotomy allowed us to discover this unusual presentation in this patient.