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Spontaneous uterine rupture at 28 weeks: A case report
Mahreen Rasool1, Imrana Masroor1, Shafia Shakoor2
1Department of Radiology, Aga Khan University Hospital, Karachi.
JPMA. the Journal of the Pakistan Medical Association
|July 19, 2016
Summary
Spontaneous uterine rupture during pregnancy is a rare but life-threatening emergency. This case highlights the critical importance of prompt diagnosis and surgical intervention for a successful outcome in high-risk pregnancies.
Area of Science:
- Obstetrics and Gynecology
- Surgical Case Reports
- Maternal-Fetal Medicine
Background:
- Spontaneous uterine rupture is a rare obstetric emergency with significant maternal and fetal morbidity.
- Risk factors include previous uterine surgeries and uterine abnormalities.
- Placenta percreta, an abnormal placental invasion, increases the risk of uterine rupture.
Observation:
- A 32-year-old multigravida at 28 weeks gestation presented with acute abdominal pain and tenderness.
- History of liver cysts, previous cesarean, and uterine curettage.
- Ultrasound revealed placenta percreta; CT abdomen showed hemoperitoneum.
Findings:
- The patient experienced spontaneous uterine rupture at the cornual site.
- Emergency cesarean hysterectomy was performed due to the severity of the rupture and bleeding.
- Massive intra-peritoneal hemorrhage was noted.
Implications:
- This case underscores the need for high vigilance in managing pregnancies with risk factors for uterine rupture.
- Early recognition and multidisciplinary management are crucial for patient survival.
- Placenta percreta in conjunction with prior uterine interventions poses a substantial risk for catastrophic uterine events.
