Spontaneous Rupture of the Gravid Uterus in a Multigravida Women with a Previous History of Caesarean Section: A Case Report
Published: February 1, 2024 | DOI: https://doi.org/10.7860/JCDR/2024/66716.19063
Shriram Natarajan, Sundara Raja Perumal, Senthil Kumar Aiyyappan, Shubhashree Thiruselvam
1. Assistant Professor, Department of Radiology, SRM Medical College Hospital and Research Centre, Potheri, Chennai, Tamil Nadu, India.
2. Professor, Department of Radiology, SRM Medical College Hospital and Research Centre, Potheri, Chennai, Tamil Nadu, India.
3. Professor and Head, Department of Radiology, SRM Medical College Hospital and Research Centre, Potheri, Chennai, Tamil Nadu, India.
4. Assistant Professor, Department of Obstetrics and Gynaecology, SRM Medical College Hospital and Research Centre, Potheri, Chennai, Tamil Nadu, India.
Correspondence
Sundara Raja Perumal,
Professor, Department of Radiodiagnosis, SRM Medical College Hospital and Research Centre, SRM Nagar, Katankulathur, Chengalpattu District, Chennai-603203, Tamil Nadu, India.
E-mail: majsundp@srmist.edu.in
Spontaneous uterine rupture is a rare obstetric complication that has catastrophic effects on both the mother and foetus, resulting in significant morbidity and 80 to 90% foetal mortality. Rupture of the uterus through a previous lower uterine segment scar is the most common cause in developing nations. However, factors such as lack of antenatal care, inappropriate obstetric interventions, obstructed labour, grand multiparity, unbooked status, limited access to emergency obstetric care, and low socioeconomic status play a crucial role in uterine rupture in developing countries like India. Hereby, the authors present a case report of a 31-year-old pregnant patient at 19 weeks of gestation with sudden severe lower abdominal pain. An ultrasound revealed the absence of foetal cardiac activity, placenta located outside the uterus, an empty endometrial cavity, and minimal free fluid in the pelvis. Further, an Magnetic Resonance Imaging (MRI) of the pelvis showed a rupture of the anterior and right lateral uterine wall, through which the foetus and most of the placental tissue had passed into the peritoneal cavity. After confirming the diagnosis, the patient underwent emergency laparotomy, during which the uterine wall defect was closed with appropriate haemostasis. The patient recovered without any untoward complications.
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