Abstract
IntroductionUterine rupture is an obstetric complication associated with significant maternal and fetal morbidity and mortality. This disorder usually occurs with a scarred uterus, especially in a uterus with prior Cesarean section. Uterine sacculation or diverticulum may also lead to a thin uterine wall during pregnancy.Case presentationA 27-year-old Japanese primigravid woman was admitted to our hospital due to weak, irregular uterine contractions in her 38th week of gestation. She had no past history of uterine surgery or known diseases. A hard mass was palpable in her abdomen. An ultrasound revealed that the anterior uterine wall was thin and bulging, with a fetal minor part beneath it which corresponded to the palpated mass. A Cesarean section was performed which revealed a thin anterior uterine wall with incomplete uterine rupture. The woman and baby were healthy.ConclusionsAlthough extremely rare, an unscarred primigravid uterus can undergo incomplete rupture even without discernable risk factors or labor pains. Abdominal palpation and ultrasound may be useful in detecting this condition.
Highlights
Uterine rupture is an obstetric complication associated with significant maternal and fetal morbidity and mortality
Abdominal palpation and ultrasound may be useful in detecting this condition
A few reports have indicated that a uterine rupture can occur in primigravida, this is extremely rare [2,3], with etiological or risk factors including a history of uterine surgery, labor augmentation or underlying connective tissue disease [2,3,4]
Summary
Uterine rupture is an obstetric complication associated with significant maternal and fetal morbidity and mortality. Case presentation A 27-year-old Japanese primigravid woman was admitted to our hospital because of slight uterine contractions at 38 +6 weeks of gestation An attending doctor performed an ultrasound examination, which revealed normal placentation without myoma and an amniotic fluid index of 15 cm (normal range: 5-25 cm) He did not comment on the uterine wall thickness. An unscarred uterus and the absence of regular contractions reduced the possibility of an impending uterine rupture, ultrasound findings led us to suspect it and an emergent Cesarean section was performed. Her vesicouterine fold was located in the normal position and her bladder did not overlay the lower uterine segment. The patient and her baby were healthy six months after the birth
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