Rupture of uterus [fundus]; spontaneous rupture of an unscarred uterus [fundus], at 35 weeks 01 day of gestation of a multigravida

ABSTRACT

Rupture of a gravid uterus is a surgical emergency. Predisposing factors include a scarred uterus. Spontaneous rupture of an unscarred uterus during pregnancy is a rare occurrence. We hereby present the case of a spontaneous complete uterine rupture at a gestational age of 35 weeks 01 day in a 25 years old patient. The case was managed at the Civil Hospital Bahawalpur. She had past history of one uterine curettage for endometrial polyp one year back. She presented with mild abdominal pains of sudden onset. After conservative management for 10 hours in hospital she suddenly developed severe abdominal pains with P/V bleeding. On ultrasound scan, uterine rupture was diagnosed and an emergency laparotomy was done. The ruptured amniotic sac with baby and placenta were found in the peritoneal cavity with rupture of the uterine funds. Spontaneous uterine fundus rupture usually occurs when there is an upper segment uterine scar. This case report shows that past history of curettage is a risk factor for the presence of uterine scar