Spontaneous Uterine Scar Rupture During The Second Trimester: A Rare But Life-Threatening Emergency

Abstract

Uterine rupture in pregnancy is a fatal condition that majorly occurs during third trimester of pregnancy, making it complicated to manage. We are presenting case report of two patients of different age groups. A 42-year-old woman with a history of a previous caesarean section and multiple spontaneous abortions presented with acute abdominal pain and distension at 21 weeks of gestation. Ultrasound showed haemoperitoneum and placental lakes, suggesting placenta accreta. Laparotomy revealed uterine rupture of previous caesarean scar, leading to subtotal abdominal hysterectomy. The second case was a 19-year-old woman with a history of a previous caesarean section presented with acute abdomen at 23+6 weeks of gestation. Ultrasound revealed haemoperitoneum while laparotomy identified a vertical uterine scar defect with placental tissue protruding. Placenta was delivered, and the scar was repaired with tubal ligation. Both the patients recovered well and discharged uneventfully. Despite its rarity, mid-trimester uterine rupture necessitates a high index of suspicion and timely surgical intervention in patients who had uterine surgery to avoid considerable maternal mortality and complications.