Spontaneous rupture of unscarred uterus secondary to placental percreta in the third trimester of pregnancy after IVF and embryo transfer: a case report

Abstract

Background: It is very rare for a young woman to experience spontaneous rupture of an unscarred uterus. Clinicians usually have a low clinical index of suspicion and may underestimate the possibility of a uterine rupture, leading to neonatal mortality in particular circumstances. We presented an incidence of spontaneous rupture of an unscarred uterus induced by placenta percreta in the third trimester of pregnancy. Case: A 27-year-old woman with an unscarred uterus, at a gestation of 31 weeks and 4 days, was presented with the right epigastric pain and vomiting after 10 hours of admission. Relevant symptomatic treatment was prescribed but did not release the related symptoms. Furthermore, an emergent exploratory laparotomy and cesarean section were conducted after the presence of hypotension and abnormal fetal heart rate, during which a spontaneous rupture of an unscarred uterus occurred, resulting in stillbirth and intraperitoneal hemorrhage. The pathological examination confirmed placental percreta as the cause of the rupture. Conclusions: IVF-ET may be a risk factor of UR and placental percreta. Potential uterine rupture should be considered for pregnant women receiving IVF-ET when they complain of abdominal pain and abnormal fetal heart rate. This case highlights the importance of identifying the risk factors for placental percreta so that patients at risk would benefit from an antenatal detection of abnormal placentation.

Spontaneous Rupture of Unscarred Uterus in a Term Primagravida with Lethal Skeletal Dysplasia Fetus (Thanatophoric dysplasia). A Case Report and Review of the Literature

“…In addition to prior uterine surgery, 9 , 19 uterine rupture has been reported in women with uterine anomalies 17 , 22 and abnormal placentation. 23 , 24 Uterine rupture was also linked to uterine adenomyosis, 25 dilatation and curettage, 26 , 27 and maternal connective tissue disease, specifically Ehlers-Danlos syndrome. 28 Labor induction with misoprostol 11 , 29 and labor augmentation with oxytocin 30 were linked to uterine rupture in unscarred women.…”