Spontaneous Rupture of an Unscarred Uterus in the Second Stage of Labour: A Case Report and Review of Literature

Abstract

Background: Uterine rupture is a rare, but severe pregnancy complication. It is mostly associated with history of uterine surgery, especially previous cesarean section but can rarely occur in unscarred uterus. Diagnosing this condition in the absence of uterine scar requires a high degree of suspicion and fetal heart tracing abnormalities remain the most common symptom. Case Report: 21-year-old G2P1 was admitted in latent labour. Pitocin was used for augmentation. Fetal heart tracing was in category 1 except an episode of bradycardia accompanied by uterine tachysystole that was resolved by resuscitative measures and turning off Pitocin. Later in the labour course, the FHT showed recurrent late and variable decelerations, cervix was found to be fully dilated at the time. Pushing was started and following a prolong deceleration, cesarean section was performed that showed a uterine rupture in the posterior wall of uterus. Conclusion: Although rare, uterine rupture should be considered as a diagnosis even in the absence of uterine scar as the main risk factor.