Spontaneous Unscarred Uterine Rupture at 15 Weeks of Pregnancy: A Case Report.

BACKGROUND: Uterine rupture during pregnancy is a serious obstetric complication. The presence of a previous uterine scar is the most important risk factor, whereas rupture in an unscarred uterus is a rare event.

CASE REPORT: A 34-year-old woman, gravida 3 para 1, presented with sudden acute hypogastric pain at 15 weeks of gestation. The patient had no history of cesarean delivery. Ultrasound scans showed an empty endometrial cavity continuing directly into the amniotic sac that developed mainly outside the uterus. Because of the ultrasound findings and the patient's progressive anemia, a laparoscopy was performed that revealed a massive hemoperitoneum caused by the rupture of the uterine fundus with exteriorization of most of the amniotic sac. Laparoscopy was converted to laparotomy, the pregnancy was removed, and the uterine disruption was repaired.

CONCLUSION: Early diagnosis and prompt treatment of uterine rupture may significantly improve prognosis. This severe obstetric complication should be considered even in early gestational age pregnancies and in the absence of known risk factors.