Uterine rupture usually occurs in a scarred uterus, especially secondary to prior cesarean section. Antepartum uterine rupture in an unscarred uterus is extremely rare. We report a case of spontaneous rupture of an unscarred gravid uterus at 32 weeks of gestation in a primigravid woman. Ultrasonography and magnetic resonance imaging showed a bulging cystic lesion communicating with the intrauterine cavity. Operative findings during emergent cesarean section revealed uterine perforation in the right cornual area and a prolapsed, nonbleeding amniotic sac. The left cornual area was also focally thin. An arcuate uterus was suspected based on follow-up hysterosalpingography. Antepartum uterine rupture tends to occur in the uterine cornual area. In this case, Müllerian duct anomalies may have been associated with focal myometrial defects.

Key Clinical MessageAn important part of anti–N‐methyl‐d‐aspartate (NMDA) receptor encephalitis treatment is prompt detection and removal of any associated ovarian teratoma, regardless of size. High‐resolution transvaginal ultrasonography followed by targeted CT with adaptive iterative dose reduction (AIDR) is a useful strategy for distinguishing small ovarian teratomas from luteal cysts during pregnancy.

In the conditions of our study, LMAs inserted with the cuff either fully inflated or deflated worsened PST compared with TTs.

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