Sealed-Off Uterine Rupture: A Report of a Rare Case

Uterine rupture is a rare but potentially life-threatening obstetric complication, most commonly associated with labor in women with a scarred uterus. However, spontaneous rupture in an unscarred uterus, particularly in the second trimester and in primigravida patients, is exceedingly rare and often underrecognized. We present the case of a 26-year-old primigravida woman at approximately 21 weeks of gestation who presented with acute abdominal pain and vaginal bleeding. Ultrasound revealed a 3.1 cm defect in the uterine fundus, with herniation of fetal parts suggestive of a sealed-off uterine rupture. Fetal demise was confirmed sonographically. This case highlights the importance of maintaining a high index of suspicion for uterine rupture, even in early gestation and in the absence of prior uterine surgery. Radiological imaging, especially ultrasonography, is pivotal in early diagnosis and timely intervention to minimize maternal risk.