Report of A Case of Uterine Rupture in Pregnant Women Without Scar After Vaginal Delivery

 Uterine rupture in pregnancy and labour is a fetal complication. Prevalence of uterine rupture in pregnancy in women with no previous uterine scare specially, nulliparous women without any risk is rare. Risk factors of uterine rupture in women with no previous scare are such as trauma, obstetrics maneuvers, high parity, multiple babies and uterotonic agents.

A 23 years woman with prime gravid, term pregnant was admitted in with chief complaint of uterine contractions. In the first examination shows: dilatation:4-5 cm, effacement : 50%, station: -2 and FHR:145. In full dilatation and complete effacement mother was exhusted. Due to her lack of cooperation in the 2nd Stage fundal pressure has been performed. After 5 minutes a baby with Apgare Score 3/4 has been born. Weighing 3500 grms. Placenta and itchr('39')s appendix completely evacuated. Uterine massages has been performed. Hemorrhage was heavy. Cervix was observed it was intac. Uterine agents and two hand uterine massage has been performed but there was persistent hemorrhage. Patient complaints of sharp pain in the abdomen. Corrugated has been done, there was no remains. Patient was suspected to uterine rupture. Immediately she was shifted to op room. In laparotomy uterine rupture in the fundus and body has been observed and repaired by gynecologist. After 72 hrs patient has been discharged from hospital with normal state.

 we recommend which in the patient with fundal pressure specially with bradycardia an internal evaluation to be performe. In case of uterine rupture diagnosis, therefore rapid actions can be done.