A rare case report of rupture uterus with full fetus in bladder

Sujata Singh, Lopamudra Jena, Sujata Swain, Subhashree Rout


Uterine rupture is the primary concern when a patient chooses a trial of labour after a caesarean section. Bladder rupture accompanied by uterine rupture should be taken into consideration if gross haematuria occurs. We report the case of a patient with uterine rupture during a trial of labour after cesarean delivery. Her course of labour went into obstructed labour and failed forceps delivery for which she was referred to our tertiary care hospital. Intra -operatively she was found to be a case of rupture uterus with rupture of bladder and full fetus lying in the bladder which was delivered by giving incision on the anterior bladder wall. Patient had subtotal hysterectomy with repair of bladder done with suprapubic cystostomy. Her postoperative recovery was uneventful.  Bladder injury and uterine rupture can occur at any time during labour. Gross haematuria immediately after delivery is the most common presentation. The incidence of rupture uterus and associated bladder injury is on increase due to higher rates of caesarean section. But there are no case reports on full fetus inside the bladder, so it is justified to report this case.

Full Text:



WHO systematic review of maternal mortality and morbidity: The prevlence of uterine rupture. BJOG: An International Journal of Obstetrics and Gynaecology. 2005;112:1221–8.

Stamilio DM, DeFranco E, Pare E, Odibo AO, Peipert JF, Allsworth JE. et al. Short interpregnancy interval: risk of uterine rupture and complications of vaginal birth after cesarean delivery. Obstet Gynecol. 2007;110:1075–82.

Guise J-M, McDonagh MS, Osterweil P, Nygren P, Chan B, Helfand M. Systematic review of the incidence and consequences of uterine rupture in women with previous caesarean section. BMJ2004;329:1-7.

Quilligan EJ. Vaginal birth after cesarean section: 270 degrees. J Obstet Gynaecol Res. 2001;27:169-73.

Rageth JC, Juzi C, Grossenbacher H. Delivery after previous cesarean: a risk evaluation. Obstet Gynecol. 1999;93:332-7.

McMahon MJ. Vaginal birth after cesarean. Clin Obstet Gynecol. 1998;41:369-81.

Yap OWS, Kim ES, Laros RK. Maternal and neonatal outcomes after uterine rupture in labor. Am J Obstet Gynecol. 2001;184:1576-81.

Rajaram P, Agarwal A, Swain S. Determinants of maternal mortality: a hospital based study from South India. Indian J Matern Child. 1995;6(1):7-10.

Smith JG, Mertz HL, Merrill DC. Identifying risk factors for uterine rupture. Clin Perinatol. 2008;35:85-99.

Bergeron ME, Jastrow N, Brassard N, Paris G, Bujold E. Sonography of lower uterine segment thickness and prediction of uterine rupture. Obstet Gynecol. 2009;113:520-2.

Kattan SA. Maternal urological injuries associated with vaginal deliveries: change of pattern. Int Urol Nephrol. 1997;29: 155-61.

Popli K, Puri M, Gupta A. Cord prolapse though the urethra. Aust N Z J Obstet Gynaecol. 2002;42:413.

O’Grady JP, Prefontaine M, Hoffman DE. Vernixuria: another sign of uterine rupture. J Perinatol. 2003;23:351-2.

Gupta A, Chauhan M, Dahiya P, Sangwan K. Meconium stained urine: an unusual sign of combined uterine and bladder rupture. Aust N Z J Obstet Gynaecol. 2005;45:334.