Spontaneous uterine rupture: report of two cases

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Reproductive Health

Background:

• Uterine rupture is a rare obstetric complication with a 0.07% incidence.
• Previous uterine scars are the primary cause, but conditions like placenta percreta can also lead to rupture.
• Spontaneous uterine ruptures account for approximately 80% of cases, carrying significant risks for maternal and fetal mortality.

Observation:

• Case 1: A 28-year-old pregnant patient at 20 weeks gestation with uterus didelphys presented with severe abdominal pain and vaginal bleeding.
• Case 2: A 20-year-old female with a history of spontaneous abortion experienced sudden abdominal pain, diarrhea, dizziness, and fainting, initially unaware of her pregnancy.

Findings:

• Both cases illustrate the diverse clinical presentations of uterine rupture, emphasizing the need for high clinical suspicion.
• Uterine rupture, though infrequent, is associated with substantial perinatal mortality.
• Prompt diagnosis and intervention are critical for managing uterine rupture and mitigating adverse outcomes.

Implications:

• Highlights the importance of considering uterine rupture in pregnant and even non-pregnant individuals presenting with acute abdominal pain and bleeding.
• Underscores the need for advanced diagnostic capabilities and rapid surgical intervention in suspected cases of uterine rupture.
• Emphasizes the critical role of clinical vigilance in managing rare but life-threatening obstetric emergencies to improve maternal and fetal survival rates.