Uterine rupture in a primigravid patient with an unscarred bicornuate uterus at term.

Background: Uterine rupture of an unscarred primigravid uterus is an exceedingly rare event. Cases of spontaneous rupture of an unscarred bicornuate uterus have been reported, but typically occur in the first or second trimester.

Case: A 28-year-old primigravida at 37 weeks gestation with a known bicornuate uterus and no prior surgery underwent an emergent cesarean section after presenting with severe abdominal pain and signs of fetal compromise. She was found to have a uterine rupture with the fetus free in the abdomen accompanied by a large hemoperitoneum. Both mother and baby did well postoperatively.

Conclusion: Bicornuate uterus may be an independent risk factor for uterine rupture, which can occur in primigravid patients and at any gestation.