Sealed-Off Uterine Rupture: A Report of a Rare Case

TL;DR

A rare case of sealed-off uterine rupture in a first-time pregnant woman is reported, emphasizing the need for early diagnosis to prevent maternal complications.

Contribution

This report adds to the limited literature on spontaneous uterine rupture in early pregnancy without prior uterine scarring.

Findings

A 26-year-old primigravida woman presented with a sealed-off uterine rupture at 21 weeks gestation.

Ultrasonography was critical in diagnosing the rupture and confirming fetal demise.

The case underscores the importance of considering uterine rupture in early pregnancy without prior uterine surgery.

Abstract

Uterine rupture is a rare but potentially life-threatening obstetric complication, most commonly associated with labor in women with a scarred uterus. However, spontaneous rupture in an unscarred uterus, particularly in the second trimester and in primigravida patients, is exceedingly rare and often underrecognized.

We present the case of a 26-year-old primigravida woman at approximately 21 weeks of gestation who presented with acute abdominal pain and vaginal bleeding. Ultrasound revealed a 3.1 cm defect in the uterine fundus, with herniation of fetal parts suggestive of a sealed-off uterine rupture. Fetal demise was confirmed sonographically.

This case highlights the importance of maintaining a high index of suspicion for uterine rupture, even in early gestation and in the absence of prior uterine surgery. Radiological imaging, especially ultrasonography, is pivotal in early diagnosis and timely intervention to minimize maternal risk.

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