Spontaneous uterine rupture masquerading as intestinal perforation in a primigravida with polyhydramnios
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20252757Keywords:
Hemoperitoneum, Uterine rupture, Chronic pelvic inflammationAbstract
Spontaneous rupture of an unscarred uterus in a primigravida is an exceptionally rare and life-threatening event. We report the case of a 26-year-old primigravida at 36 weeks who was referred as a suspected case of intestinal perforation. Cross-sectional imaging revealed a uterine fundal rent with hemoperitoneum. Intraoperative findings included dense pelvic adhesions, fat stranding, and a ruptured dilated vessel over the uterine rent, suggestive of chronic pelvic inflammation possibly due to endometriosis or prior subclinical pelvic inflammatory disease. This case highlights the importance of considering uterine rupture in unscarred uteri, particularly when atypical presentations occur.
Metrics
References
Sun HD, Su WH, Chang WH, Wen L, Chen M. Spontaneous uterine rupture in an unscarred uterus: a rare but life-threatening event. Am J Emerg Med. 2012;30(9):5-7.
Ofir K, Sheiner E, Levy A, Katz M, Mazor M. Uterine rupture: risk factors and pregnancy outcome. Am J Obstet Gynecol. 2003;189(4):1042-6. DOI: https://doi.org/10.1067/S0002-9378(03)01052-4
Yasmin F, Mubeen N, Goraya S. Spontaneous rupture of unscarred uterus in a primigravida at 32 weeks: a rare case report. J Pak Med Assoc. 2020;70(11):2083-5.
Breen JL, Neubecker R, Gregori CA, Franklin JE. Spontaneous rupture of the uterus. Obstet Gynecol. 1977;50(5):541-6.
Benagiano G, Brosens I, Habiba M. Structural and molecular aspects of uterine rupture in pregnancy. J Matern Fetal Neonatal Med. 2012;25(1):17-20.
Kamara M, Penava D, Jaeger M, Mehta S. Spontaneous rupture of the uterus in the third trimester after an uneventful vaginal birth. J Obstet Gynaecol Can. 2013;35(10):928-32.
Brosens I, Brosens JJ, Fusi L, Al-Sabbagh M, Kuroda K, Benagiano G. Risks of adverse pregnancy outcomes in endometriosis. Fertil Steril. 2012;98(1):30-5. DOI: https://doi.org/10.1016/j.fertnstert.2012.02.024
Leone Roberti Maggiore U, Ferrero S, Mangili G, Bergamini A, Inversetti A, et al. A systematic review on endometriosis during pregnancy: diagnosis, misdiagnosis, complications and outcomes. Hum Reprod Update. 2016;22(1):70-103. DOI: https://doi.org/10.1093/humupd/dmv045
Varras M, Akrivis C, Kalles V, Plis C. Endometriosis causing uterine rupture during pregnancy: a case report. Cases J. 2009;2:9327. DOI: https://doi.org/10.1155/2009/180643