Kelly Albrecht1, Gail Lam1. 1. Department of Obstetrics and Gynaecology, University of Calgary, Calgary AB.
Abstract
BACKGROUND: Uterine rupture can be a catastrophic obstetrical emergency. Many risk factors for uterine rupture have been identified, as well as a wide range of clinical presentations. In this case report, we describe the occurrence of fetal death and uterine rupture in a non-labouring, preterm patient. CASE: A 32-year-old woman, gravida 10, para 7, who had three previous lower segment Caesarean sections, presented with minor abdominal pain and vaginal bleeding. Fetal demise was confirmed on ultrasound examination. Delivery of the fetus by lower segment Caesarean section was planned, but at laparotomy a complete uterine rupture was found, with the amniotic sac intact in the mother's abdomen. CONCLUSION: Uterine rupture can be a fatal event for the fetus, with the mother experiencing only minor symptoms. In managing patients with risk factors for uterine rupture, clinicians must always keep the possibility of rupture in mind. Abdominal trauma and intercourse may be added risk factors for uterine rupture.
BACKGROUND: Uterine rupture can be a catastrophic obstetrical emergency. Many risk factors for uterine rupture have been identified, as well as a wide range of clinical presentations. In this case report, we describe the occurrence of fetal death and uterine rupture in a non-labouring, preterm patient. CASE: A 32-year-old woman, gravida 10, para 7, who had three previous lower segment Caesarean sections, presented with minor abdominal pain and vaginal bleeding. Fetal demise was confirmed on ultrasound examination. Delivery of the fetus by lower segment Caesarean section was planned, but at laparotomy a complete uterine rupture was found, with the amniotic sac intact in the mother's abdomen. CONCLUSION: Uterine rupture can be a fatal event for the fetus, with the mother experiencing only minor symptoms. In managing patients with risk factors for uterine rupture, clinicians must always keep the possibility of rupture in mind. Abdominal trauma and intercourse may be added risk factors for uterine rupture.