Term delivery after repair of a uterine rupture during the second trimester in a previously unscarred uterus: a case report.

BACKGROUND

Rupture of the unscarred gravid uterus is very rare. The event occurs mostly during the intrapartum period and is potentially catastrophic for both mother and fetus. The management in general is prompt termination of pregnancy and hysterectomy.

CASE

A successful term delivery followed spontaneous rupture of the uterus during the second trimester and surgical repair. The uterus ruptured with no apparent risk factors at 26 weeks of gestation. The rent, at the right side of the fundus, was repaired without damaging the amniotic membrane. After the operation, the patient received tocolysis for irregular uterine contractions until 37 weeks' gestation and delivered a healthy, male infant by cesarean section.

CONCLUSION

Spontaneous rupture of a nonlaboring, unscarred uterus, especially in the second trimester, is extremely rare. This report suggests that conservative treatment for spontaneous rupture of the uterus before fetal maturity may be considered as an alternative to hysterectomy.