Rupture of the unscarred uterus in pregnancy – a life-threatening event

Abstract

The rupture of an unscarred uterus in pregnancy may result in catastrophic consequences for both mother and baby. This is usually related to a delayed diagnosis and treatment, because of a low index of suspicion. There have been described a series of risk factors incriminated in unscarred uterine rupture, such as abdominal trauma, labor induction, obstructed or neglected labor, and operative vaginal deliveries. Although it is a rare event that happens more often in old multiparous patients, there have been reported cases of uterine rupture in primiparous women. A uterine rupture is an unpredictable event that happens suddenly, can have dramatic, but non-specific symptoms, and requires a high index of suspicion and prompt management to reduce maternal and neonatal morbidity and mortality. The purpose of this study is to synthesize available information about the rupture of the unscarred uterus, its risk factors, diagnosis, and management.