Uterine rupture during labor in a patient with endometriosis: A case report

Uterine rupture is a rare obstetric complication, particularly in women without a prior cesarean delivery. This report describes an intrapartum posterior uterine wall rupture extending into the vagina in a patient with pre-existing endometriosis and presumed adenomyosis, highlighting endometriosis and its surgical management as potential risk factors. A term gravida with a history of two laparoscopic procedures for endometriosis presented with menstrual-like bleeding and contractions. During labor, she developed severe abdominal pain, prompting an emergency cesarean section. Intraoperatively, a 12 cm longitudinal rupture of the posterior uterine wall extending into the pouch of Douglas and the posterior vaginal fornix was identified. The defect was successfully sutured, and hysterectomy was not required. The postpartum outcome for both the mother and the newborn was satisfactory. This case underscores the importance of recognizing endometriosis and its surgical treatment as possible contributing factors to uterine rupture.