Abstract
Uterine rupture is a rare and catastrophic incidence with high maternal and fetal morbidity rates. It is most commonly seen in the scarred uterus. The unscarred uterus is least susceptible to rupture with the incidencebeing 1 in 8000 deliveries. In the past, pregnancy after uterine rupture was not widely advised and patients underwent hysterectomy or tubal ligation but with the evolving practice, women are motivated for pregnancy which can be successful with proper obstetric care and emphasis on time and mode of delivery. Here we present a case of 31 years old female, gravida-2 para-1 living 0 with previous uterine rupture after medical induction of labor with stillbirth 4 years ago. She underwent emergency laparotomy with the repair. The patient spontaneously conceived and had close antenatal care throughout the pregnancy. The patient was admitted at 34 weeks of gestation and kept under close surveillance. Corticosteroid was administered. She underwent spontaneous labor at 37 weeks of gestation and emergency cesarean section was planned, delivered via a breech presentation to a live baby of 2.4 kg, APGAR score of 8/10, 9/10 at 1 and 5 minutes.
Highlights
Uterine rupture is a formidable incidence with the potentially life-threatening and devastating condition
A 31 years old female Gravida 2 Para 1 Living 0 was admitted to our institution at 34 weeks of gestation with a history of previous uterine rupture 4 years ago
The patient had rupture after induction of labor. These risk factors contributed to 84% of uterine ruptures in a study conducted by Uprety et al.[3]
Summary
Uterine rupture is a formidable incidence with the potentially life-threatening and devastating condition. A 31 years old female Gravida 2 Para 1 Living 0 was admitted to our institution at 34 weeks of gestation with a history of previous uterine rupture 4 years ago. Four years ago the patient was admitted at 41 weeks 2 days of gestation for induction of labor. She was inducted medically with misoprostol 25mcg per vagina 4 hourly for 3 doses. Labor was augmented with 2.5U oxytocin 6 hours after the last dose of misoprostol She developed moderate contraction until she started having severe abdominal pain with a sudden drop in blood pressure and uterine rupture was suspected and emergency laparotomy was done. At 37 weeks of gestation, the patient went into labor and an emergency cesarean section was done. Upon follow up at 1 week, both patient and baby were healthy
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