Case Report on Spontaneous Uterine Rupture in the Early Second Trimester: A Rare but Life-Threatening Event

Spontaneous uterine rupture during the first half of pregnancy is extremely uncommon and presents significant diagnostic and therapeutic challenges. This case report details a 27-year-old gravida 3 para 1 woman at 14 weeks of gestation who experienced acute abdominal pain and hypovolemic shock. Despite the absence of previous uterine surgery, imaging revealed a significant hemoperitoneum, and subsequent emergency laparoscopic and laparotomy validated a uterine fundal rupture attributable to placenta accreta spectrum (PAS). The uterus was successfully preserved after surgical repair. Histopathological examination confirmed localized myometrial infiltration by placental tissue, consistent with PAS. This report emphasizes the necessity of including PAS-related uterine rupture in the differential diagnosis of acute abdomen during early pregnancy, even when classical risk markers are absent. The example underscores the need of timely surgical intervention in securing positive mother outcomes and maintaining reproductive potential. The postoperative course was uneventful, and the patient was discharged in stable condition with preservation of uterine integrity. This article seeks to enhance clinical knowledge and promote vigilance among obstetricians and emergency physicians on early-pregnancy uterine rupture by contributing to the scarce literature on the subject.