Background: Rupture of an unscarred uterus is an uncommon but potentially life-threatening event associated with maternal and fetal morbidity and mortality. Patients lacking common identifiable risk factors can lack appropriate cautions or lead to delayed diagnosis. Case report: A 24-year-old woman, gravida 5, para 2, with single gestation at 41 weeks and 1 day was admitted to the labor unit with regular uterine contractions. Her obstetrical history was significant for two previous uncomplicated spontaneous vaginal deliveries, one ectopic pregnancy and one missed abortion. Her medical history was unremarkable. Her surgical history was significant for a congenital diaphragmatic hernia repair as an infant and dilation and curettage for missed abortion. During an uneventful labor, a sudden loss of fetal station and decelerations to 80 beats/min occurred, leading to an emergent caesarean section. A 4 cm rupture site at the left lower uterine segment posterior to the uterine artery was found, and the infant was delivered through this site. The uterus was repaired without complication and maternal postpartum course was uncomplicated, leading to discharge on post-operative day #4. The neonate was discharged from the NICU on day of life #5. Conclusion: Additional risk factors may exist in patients with a history of uterine rupture of an unscarred uterus than previously have been identified. Possible defects in formation of collagen leading to increased risk of uterine rupture should not be discounted in a patient with a history of a potential collagen vascular disorder.
Clinical Medical Reviews and Case Reports
Grassi, A., Scott, B., Cammarano, D., Jiang, X., & Schnatz, P. F. (2015). Posterior Uterine Wall Rupture of an Unscarred Uterus in a Woman with History of Congenital Diaphragmatic Hernia Repair. Clinical Medical Reviews and Case Reports, 2 (9) https://doi.org/http://dx.doi.org/10.23937/2378-3656/1410059