Spontaneous rupture of an unscarred uterus in a multipara at 32 weeks of gestation: A case report

Abstract

Uterine rupture is still a public health problem in developing countries. Most spontaneous uterine rupture in this region occurs in unscarred uterus due to prolonged obstructed labor and injudicious use of oxytocics. Antepartum uterine rupture is uncommon; the diagnosis is not always obvious; and maternal, fetal morbidity and mortality are high. A 30-year-old gravida 7 para 5 +1 2alive, at 32 weeks of gestation, booked in a primary healthcare center and presented with sudden onset abdominal pain and vaginal bleeding of 4-h duration. Ultrasound scan revealed a major degree placenta previa; however, intraoperatively an anterior uterine rupture was detected with a fresh still-born male fetus weighing 1,650 g with intact membranes within the abdominal cavity. She had a subtotal hysterectomy performed. This case highlights the occurrence of spontaneous uterine rupture in an unscarred uterus; increased awareness on the need for early presentation enables prompt diagnosis and treatment.