Spontaneous Antepartum Posterior Wall UterineRupture in an Unknown Pregnancy

Abstract

Background: Uterine rupture is a rare but fatal complication of pregnancy, which should be diagnosed and treated prompt ly. Majority of rupture occur during labor in scarred uterus, though very rare, uterine rupture may also occur antepartum. Case Report: A 32-year-old woman presented with spontaneous antepartum posterior wall uterine rupture with an un known pregnancy, complaining with abdominal pain and impaired consciousness. At physical examination, she had a firmfullness at abdomen. The ultrasound was inconclusive due to intra-abdominal gas, except for pelvic free fluid, and computedtomography scans showed an intra-abdominal dead fetus. Surgery revealed a wide perforation at the posterior wall of uterusand massive hemoperitoneum, in addition to a dead fetus. The patient underwent hysterectomy due to poor tissue qualityand extensive perforation. She made an uneventful recovery and was discharged at the end of 2 week. Conclusion: Correct clinical history plays a major role in diagnosis. An enlarged uterus in a patient with previous cesareansection should alert the radiologist for uterine rupture. Whenever ultrasound imaging is insufficient to clarify the clinical man ifestation, further imaging should be obtained.