Late post-partum hemorrhage revealing a delayed uterine rupture in an unscarred uterus: a case report

Uterine rupture in an unscarred uterus is a rare, a neglected uterine rupture is rarer more serious impacting maternal prognosis with an increased rate of a hysterectomy.

A 44-year-old patient presented within 24 h postpartum in a state of shock. Clinical examination revealed a patient in shock with diffuse pelvic pain. A complementary ultrasound detected a significant peritoneal effusion extending to the Morison's pouch. Due to hemodynamic instability and the extent of the lesions, an emergency hemostatic hysterectomy was performed.

Spontaneous uterine rupture in an unscarred uterus is a rare but severe complication that can significantly impact maternal outcomes. Its occurrence is more frequent in developing countries, reflecting disparities in socioeconomic conditions and limited access to healthcare resources. The risk factors are diverse and can stem from trauma or obstetric interventions. The primary treatment approach is conservative; however, in severe cases where conservative measures are not feasible, a hysterectomy may be required.

Neglected uterine rupture in an unscarred uterus is exceptional but complicated situation with high mortality and morbidity. It requires prompt management. Uterine rupture should always be considered in the postpartum period in cases of postpartum hemorrhage, hemodynamic shock, or pelvic pain, regardless of the patient's obstetric history, whether the uterus is scarred or unscarred.