UNSCARRED UTERINE RUPTURE (UUR) IN EARLY PREGNANCY.

Abstract

Background:Uterine rupture is a devastating obstetric complication commonly occurring in uterus with scarring during labor or late pregnancy. Early trimester and rupture of unscarred uterus is an infrequent event.

Case Report:A 36-year-old woman, gravida 6 para 5+0, came with the complain of sudden generalized abdominal pain at 10+ weeks of gestation. All previous pregnancies were spontaneous vaginal deliveries and patient refused any sort of recent surgical procedure involving uterus, but had a history of consumption of misoprostol for 3 days. Transabdominal ultrasound showed increased haziness suggestive of fluid and FAST turned out to be positive for free intraperitoneal fluid. Hence, an emergency laparotomy was performed to confirm diagnosis. It revealed hemoperitoneum caused by the rupture of the uterine fundus and products of conception in peritoneal cavity with blood clots. Uterine defect was repaired and bilateral tubal ligation was performed.

Conclusion:Uterine rupture should be considered even in early gestational age pregnancies and in an unscarred uterus in a patient with hemoperitoneum as early diagnosis is associated with better prognosis.

Background:Uterine rupture is a devastating obstetric complication commonly occurring in uterus with scarring during labor or late pregnancy. Early trimester and rupture of unscarred uterus is an infrequent event.

Case Report:A 36-year-old woman, gravida 6 para 5+0, came with the complain of sudden generalized abdominal pain at 10+ weeks of gestation. All previous pregnancies were spontaneous vaginal deliveries and patient refused any sort of recent surgical procedure involving uterus, but had a history of consumption of misoprostol for 3 days. Transabdominal ultrasound showed increased haziness suggestive of fluid and FAST turned out to be positive for free intraperitoneal fluid. Hence, an emergency laparotomy was performed to confirm diagnosis. It revealed hemoperitoneum caused by the rupture of the uterine fundus and products of conception in peritoneal cavity with blood clots. Uterine defect was repaired and bilateral tubal ligation was performed.

Conclusion:Uterine rupture should be considered even in early gestational age pregnancies and in an unscarred uterus in a patient with hemoperitoneum as early diagnosis is associated with better prognosis.