Intrapartum posterior wall rupture in unscarred uterus during labour augmentation with oxytocin; a case report


  • Divya Verma Vivekanand Medical Institute Palampur, Kangra, Himachal Pradesh, India
  • Sanjeev Kumar Dr. RPGMC, Tanda at Kangra, Himachal Pradesh, India
  • Premveetrag Sharma Vivekanand Medical Institute Palampur, Kangra, Himachal Pradesh, India



Unscarred uterus, Uterine rupture, Labour augmentation, Oxytocin infusion


Intrapartum rupture of unscarred uterus during labour augmentation is an exceedingly rare occurrence with very few case reports of this entity in the literature. We intend to report such case to highlight the importance of constant vigilance during oxytocin infusion even in patients with unscarred uterus. The 27 years old lady who had a previous normal vaginal delivery, came in early labour at term gestation. Augmentation of labour was done with oxytocin. After 30 mins of starting oxytocin patient complained of severe pain abdomen and on CTG fetal heart dropped to 70 bpm. Despite all measures fetal heart rate did not pick up and patient was taken up for cesarean section. Intraoperatively, posterior uterine wall ruptured was found with baby and placenta lying in the abdominal cavity. Baby had a low Apgar score and died on third day. Uterine rupture repair was done and patient was discharged on 5th postoperative day. Although oxytocin has excellent safety record in unscarred uterus, the possibility of rupture uterus should be kept in mind in relevant clinical scenario.

Author Biography

Divya Verma, Vivekanand Medical Institute Palampur, Kangra, Himachal Pradesh, India

Dr. Divya Verma

Consultant OBG


Khanam RA, Khatun M. Ruptured uterus: an ongoing tragedy of motherhood. Bangladesh Med Res Counc Bull. 2001;27(2):43-7.

Vernekar M, Rajib R. Unscarred uterine rupture: a retrospective analysis. J Obstetr Gynecol India. 2016;66(1):51-4.

Justus Hofmeyr G, Say L, Metin Gülmezoglu A. Systematic review: WHO systematic review of maternal mortality and morbidity: the prevalence of uterine rupture. BJOG. 2005;112(9):1221-8.

Uccella S, Cromi A, Bogani G, Zaffaroni E, Ghezzi F. Spontaneous prelabor uterine rupture in a primigravida: a case report and review of the literature. Am J Obstetr Gynecol. 2011;205(5):e6-8.

Miller DA, Goodwin TM, Gherman RB, Paul RH. Intrapartum rupture of the unscarred uterus. Obstetr Gynecol. 1997;89(5):671-3.

Sweeten KM, Graves WK, Athanassiou A. Spontaneous rupture of the unscarred uterus. Am J Obstetr Gynecol. 1995;172(6):1851-6.

Al‐Zirqi I, Daltveit AK, Vangen S. Maternal outcome after complete uterine rupture. Actaobstetricia et gynecologica Scandinavica. 2019;98(8):1024-31.

Rizwan N, Abbasi RM, Uddin SF. Uterine rupture, frequency of cases and fetomaternal outcome. JPMA. 2011;61(4):322.

Guise JM, McDonagh MS, Osterweil P, Nygren P, Chan BK, Helfand M. Systematic review of the incidence and consequences of uterine rupture in women with previous caesarean section. BMJ. 2004;329(7456):19.

Obstetricians RCo, Gynaecologists. Birth after Previous Caesarean Section. Green‐Top Guideline No. 45. 2007.






Case Reports