Spontaneous second-trimester uterine rupture in the absence of known risk factors: a case report

Uterine rupture is a rare, catastrophic event in obstetrics. When it occurs, it is usually associated with prior uterine surgery, trauma, abnormal placentation, or induction of labor. Spontaneous rupture during the second trimester is exceptionally rare.

A woman with 3 prior vaginal deliveries and no history of uterine surgery, trauma or other risk factors for uterine rupture presented at 17 weeks' gestation with vaginal bleeding and an acute abdomen. A 5-cm, complete-thickness rupture of the uterine fundus was noted at surgery, and the defect was repaired. No abnormalities were noted on the pathologic specimen.

Spontaneous rupture should be considered in patients even without risk factors, regardless of gestational age.