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Preterm Complete Uterine Rupture With En Caul Expulsion.
Stanley Eboh1, Suna Burghul1, Michael Galloway1
1Texas Tech University Health Sciences Center at the Permian Basin, Odessa, TX, USA.
Clinical Medicine Insights. Case Reports
|July 18, 2022
Summary
Spontaneous uterine rupture is a rare but severe obstetric emergency. This case report details a uterine rupture with fetal demise in the abdominal cavity, emphasizing the need for continued patient counseling.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Surgical Case Reports
Background:
- Spontaneous uterine rupture is a rare but life-threatening obstetric complication.
- It necessitates prompt diagnosis and surgical intervention to ensure maternal and fetal survival.
- While often associated with previous uterine surgeries, it can occur spontaneously.
Observation:
- A 32-year-old patient at 36 weeks gestation presented with abdominal pain and vaginal bleeding.
- Ultrasound revealed an empty uterus and fetal demise within the abdominal cavity.
- Exploratory laparotomy confirmed a complete rupture of the anterior uterine wall.
Findings:
- A preterm fetus, encased in intact amnions, was found free-floating in the abdominal cavity.
- The uterine rupture was hemostatic, allowing for successful surgical repair.
- The patient experienced an uncomplicated postoperative recovery.
Implications:
- This case underscores that spontaneous uterine rupture is a critical diagnosis to consider, even with a history of low-transverse Cesarean section.
- Healthcare providers must counsel patients on the risks of uterine rupture, irrespective of the perceived low risk.
- Vigilance and preparedness are crucial for managing catastrophic obstetric events.
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