Rupture of a pregnant unscarred uterus in an early secondary trimester: A case report and brief review

Abstract

Rupture of a pregnant uterus in early pregnancy and an unscarred uterus are extremely rare, and some non-specific symptoms might appear before this occurrence. We report the case of a multiparous woman (gravida 3, para 2) with uterine fundal rupture in her early second trimester (17+ weeks of gestational age), who presented upper abdominal discomfort and vomiting for 3 days, and progressed into sudden acute abdomen and shock. During emergent laparotomy, the entire amniotic sac was found in the peritoneal cavity with a rupture of the uterine fundus. Although we could not confirm that the appearance of upper gastrointestinal symptoms and severe vomiting was associated with uterine rupture in this pregnant woman, abdominal symptoms or signs might be a hint or cause of severe catastrophic pregnancy-related complications.

Spontaneous Uterine Rupture in the Second Trimester: a Case Report

“…Reported cases in the literature suggest underlying etiologies of abnormal placenta implantation [3][4][5][6][7][8][9] and congenital uterine abnormalities such as bicornuate uterus [10] and uterine septum [2]. Occasionally, no underlying cause is found [11][12][13]. The cases are summarized in Table 1.…”

Spontaneous mid-trimester rupture of a non-scarred gravid uterus

“…But if there is fundal rupture especially in early pregnancy, the diagnosis is often delayed due to non-specific symptoms and so other causes of acute abdomen should be ruled out. 5 This case highlights that curettage can also be a risk factor for spontaneous uterine rupture in early pregnancy. …”

Spontaneous mid-trimester rupture of unscarred uterus

“…4 Sun et al also reported similar case with fundal rupture at 17 weeks gestation in gravida 3. 5 Kharakwal et al reported rupture lateral wall of uterus at 20 weeks in G5P4. 6 As compared to our case, rupture uterus in these case reports were seen in higher birth order.…”