Spontaneous uterine rupture at non-cesarean section scar site with placenta percreta in the second trimester: a case report.

BACKGROUND

Uterine rupture was a common occurrence at previously cesarean-sectioned scar Early sign ofuterine rupture was a severe fetal bradycardia.

CASE REPORT

A 30-year-old, 3 gravida, 1 para woman was presented with an acute abdominal pain and hypovolemic shock. Her gestational age was estimated at 18 weeks by emergency pelvic ultrasound. She had a lower segment scar from a previous caesarean section. Initially, alive intrauterinepregnancy with massive hemoperitoneum was a provisional diagnosis. During exploratory laparotomy, a ruptured of the right uterine fundus was found with placenta percreta. Hysterectomy was performed. Fetal weight was 450 grams, APGAR score 0, 0 and the fetus could not survive. The patient was discharged on the 4th day after surgery in healthy condition.

CONCLUSION

Uterine rupture is a catastrophic kituation. Severefetal bradycardia might be an early sign. This case demonstrates the importance ofclinical judgment based on clinical acumen.