Seventeen Week Uterine Rupture: A Case Report

Tiffany R Tonismae,Christinne Canela

doi:10.21767/2471-9803.100027

Abstract

Background: Uterine rupture occurs when there is complete or partial separation of the uterine wall. It is associated with increased morbidity and mortality for both the mother and the infant. Case: A pregnant woman presents to the emergency room complaining of two weeks of abdominal pain at 17 weeks gestation. She was evaluated in an outlying emergency department when she became unstable and was transferred to a tertiary care center. A bedside ultrasound as well as commuted tomography revealed an extrauterine fetus, and she was taken to the operating room for exploratory laparotomy. Surgery revealed complete uterine rupture at the fundus with the fetus expelled into the abdomen. Conclusion: This case offers review of a rare outcome of uterine rupture during the second trimester and risks factors to be monitored for futures cases.

Highlights

Uterine rupture is classified as complete or partial separation of the uterine walls and is often associated with high morbidity and mortality [1]
She had new onset vaginal bleeding with increasing abdominal discomfort, worse than previously. She was noted to be anemic with a hematocrit of 23 and subsequently became hypotensive, tachycardic, and diaphoretic while in the emergency department. This case offers review of a rare outcome of uterine rupture during the second trimester and risks factors to be monitored for futures cases
While uterine rupture in a patient with a prior cesarean section often occurs at the site of the prior hysterotomy scar, a case of a patient with rupture in a location unrelated to her scar is noteworthy for the literature

Summary

Background

Uterine rupture occurs when there is complete or partial separation of the uterine wall It is associated with increased morbidity and mortality for both the mother and the infant. A 32-year-old gravida 5, para 2 at 17 weeks and 1 day gestation presents to the emergency department complaining of mild abdominal pain, primarily located in the right upper quadrant, for the past month. She has previously been evaluated by both her primary obstetrician and in the emergency department of her local hospital.

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