DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20174075

A rare case of spontaneous posterior wall rupture in an unscarred uterus during labour

Kirty Nanda, Shakun Singh, Vandana Dhama, Rachna Choudhary, Renu Azad

Abstract


Uterine rupture is a dreaded catastroph in obstetrics with a high incidence of maternal and fetal morbidity. In developing Country, the overall prevalence widely varies from 1 in 2,000 to 1 in 200 deliveries. Uterine rupture in an unscarred uterus is a rare event and only a finger countable cased have been reported on posterior rupture of uterus in unscarred uterus. We here presenting a case of spontaneous posterior rupture of an unscarred uterus. Our patient was 38 years old grand multipara, a 6th gravida female with 4 parity, 1 abortion last year and 3 live issues. She was 9 months of gestation with previous all normal vaginal deliveries. This time she had a uterine rupture in the lower segment of posterior wall of uterus during labour. The rupture was unrepeatable, so we have to do hysterectomy. This case points out to keep this catastroph in mind in multiparas with unscarred uterus and to be prepared for the same while assisting a normal vaginal delivery.


Keywords


Posterior wall uterine rupture, Uterine rupture, Unscarred uterus

Full Text:

PDF

References


Cunningham FG, Leveno KJ, Bloom SL. Williams Obstetrics, 24th Ed. McGraw-Hill Education, New York, Chicago, San Francisco, New Delhi;2014. ISBN: 978-0-07-179894-5.

Dow M, Wax JR, Pinette MG, Blackstone J, Cartin. Third-trimester uterine rupture without previous cesarean: a case series and review of the literature. Am J Perinatol. 2009;26:739.

DC Dutta, Text Book of Obstetrics. 7th Ed. New Delhi, London, Philadelphia;2013. ISBN 978-93-5152-067-2.

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

Porreco RP, Clark SL, Belfort MA, Dildy GA, Meyers JA. The changing specter of uterine rupture. Am J Obstet Gynecol. 2009;200(3):269-e1.

Maymon R, Shulman A, Pomeranz M, Holtzinger M, Haimovich L, Bahary C. Uterine rupture at term pregnancy with the use of intracervical prostaglandin E2 gel for induction of labor. Am J Obstet Gynecol. 1991;165(2):368-70.

McLellan AN. Rupture of a pregnant diverticulum of the uterus. Glasgow Med J. 1916;3;390-5.

Nagy PS. Placenta percreta induced uterine rupture and resulted in intraabdominal abortion. Am J Obstet Gynecol. 1989;161:1185-6.

Saǧlamtas M, Vicdan K, Yalcin H, Yilmaz Z, Yeşilyurt H, Gökmen O. Rupture of the uterus. Int J Gynecol Obstet. 1995;49(1):9-15.

Levrant SG, Wingate M. Midtrimester uterine rupture. A case report. J Reprod Med. 1996;41:186-190.

Hawe JA, Olah KS. Posterior uterine rupture in a patient with a lower segment caesarean section scar complicating prostaglandin induction of labour. Br J Obstet Gynecol. 1997;104,:857-8.

Kindig M, Cardwell M, Lee T. Delayed postpartum uterine dehiscence. A case report. J Reprod Med. 1998;43:591-2.

Sciscione AC, Nguyen L, Manley JS et al. Uterine rupture during preinduction cervical ripening with misoprostol in a patient with previous caesarean delivery. Aus N Z J Obstet Gynecol. 1998;38:96-97.

Wing DA, Lovett K, Paul RH. Disruption of prior uterine incision following misoprostol for labour induction in women with previous Caesarean delivery. Obstet Gynecol. 1998;91:828-30.

Langton J, Fishwick K, Kumar B, Nwosu EC. Spontaneous rupture of an unscarred gravid uterus at 32 weeks gestation. Hum Reprod. 1997;12:2066-7.

Wang PH, Yuan CC, Chao HT, Yang MJ, Ng HT. Posterior uterine wall rupture during labour: Case report. Hum Reprod. 2000;15(5):1198-9.

Navaratnam K, Ulaganathan P, Akhtar MA, Sharma SD, Davies MG. Posterior uterine rupture causing fetal expulsion into the abdominal cavity: a rare case of neonatal survival. Case Reports Obstet Gynecol. 2011;2011.

Lin YH, Chen CP, Lin JR, Yeh LF, Chen TC. Third-trimester spontaneous rupture of an unscarred uterus with massive intra-abdominal hemorrhage during tocolysis in a pregnant woman who has had multiple instrumental abortions. Taiwanese J Obstet Gynecol. 2004;43(3):172-4.

Batra K, Gaikwad HS, Gutgutia I, Prateek S, Bajaj B. Determinants of rupture of the unscarred uterus and the related feto-maternal outcome: current scenario in a low-income country. Tropic Doc. 2016;46(2):69-73.