Publication:

A case report of rupture uterus in an unscarred uterus

Uterine rupture in an unscarred uterus is a rare occurrence. It is defined as A complete disruption of all layers of the uterine wall (endometrium, myometrium, and serosa), often associated with extrusion of the fetus, placenta, or both into the peritoneal cavity. A 26- year-old, P2L2 at 38 weeks + 3 days of gestation with an unscarred uterus who was induced with misoprostol and oxytocin and delivered from a local hospital was referred to this tertiary care centre with provisional diagnosis of severe postpartum haemorrhage. She was diagnosed to have posterior uterine wall rupture with huge haematoma extending to cervix, broad ligament and lower uterine segment. Active management with emergency laparotomy and obstetric hysterectomy with bilateral internal iliac artery ligation led to complete recovery of the mother with uneventful 1 month follow up. The report highlights the need to consider uterine rupture as differential diagnosis even in an unscarred uterus in case of postpartum haemorrhage and urgent referral to higher centre for timely management. Early diagnosis and immediate surgical intervention may significantly improve the prognosis.