Spontaneous rupture of a bicornuate uterus at 19 weeks gestation: A case report.

INTRODUCTION

A bicornuate uterus (BU) is one of the four principal abnormalities resulting from defective embryological development of the Müllerian ducts, associated with increased risks of miscarriage, preterm birth, and malpresentation.

CASE PRESENTATION

This case report describes a rare instance of spontaneous uterine rupture in a 31-year-old woman with a bicornuate uterus at 19 weeks of gestation. She presented with severe abdominal pain and signs of hypovolemic shock. Ultrasound revealed a single dead fetus, and surgical exploration confirmed uterine rupture with the deceased fetus free in the abdominal cavity and significant hemoperitoneum. The ruptured left uterine horn was excised, and the uterine defect was repaired. The patient's postoperative recovery was uneventful.

DISCUSSION

A bicornuate uterus is a rare anomaly that can lead to serious obstetric complications at any stage of pregnancy. In our case, despite the absence of prior indications of uterine defects, the condition was identified during an emergency diagnostic laparotomy following the exclusion of other surgical diagnoses. Uterine rupture, often linked to previous cesarean deliveries and uterine anomalies, can manifest as acute abdominal pain, vaginal hemorrhage, and fetal distress.

CONCLUSION

Uterine rupture should be included in the differential diagnosis for acute abdominal pain in mid-trimester pregnancies, particularly in cases of uterine anomalies.