Unexpected Rupture of Unscarred Uterus at 12 Weeks of Pregnancy: A Case Report and Literature Review

Uterine rupture is an infrequent but serious event in pregnancy, which happens commonly in the second and third trimesters in scarred uteruses and labor phases. Uterine rupture during labor is very rare in the absence of scar and occurs mainly in multiparous women. This article introduces a very unusual case of unexpected rupture of an unscarred uterus in the 12th week of gestation.
A 34 year old woman with a history of vaginal delivery, gravida 2, para 1, and gestational age of 12 weeks were admitted to Tabriz Taleghani hospital with abdominal pain. With increasing abdominal pain, the patient underwent ultrasound, which showed a lot of abdominal and pelvic free fluid, indicating urgent laparotomy, in which a bleeding rupture of about 5 cm was found on the posterior wall of the uterus. Placenta and fetus with an intact sac were bulging into the abdomen from the rupture site and hence were excised. The rupture was repaired and the patient was discharged on the third day in good conditions. The patient did not have any risk factors except multiparity.
Regardless of gestational age and history, uterine rupture should be kept in mind for all pregnant women with abdominal pain and signs of peritoneal irritation to timely and quickly detect and manage as a rare but life-threatening condition.