Lwamulungi Everett, Arara Corrine, Marasinghe Jeevan, Van Dam Jacqueline
Department of Obstetrics and Gynecology, Werribee Mercy Hospital, 300 Princes Highway, Werribee, Victoria 3030, Australia.
Case Rep Womens Health. 2025 Apr 29;46:e00711. doi: 10.1016/j.crwh.2025.e00711. eCollection 2025 Jun.
Spontaneous uterine rupture in the second trimester is an extremely rare but critical obstetric emergency, associated with significant maternal and foetal morbidity and mortality. A 41-year-old multiparous woman presented at 16 weeks of gestation with acute lower abdominal pain and vaginal bleeding. Initial evaluation revealed severe anaemia and haemodynamic instability. Imaging demonstrated massive hemoperitoneum and a possible placental abruption, necessitating emergency surgical intervention. Emergency laparotomy revealed a uterine fundal rupture with active bleeding and a bulging amniotic sac. The foetus was evacuated via a midline vertical uterine incision. A two-layer repair of the uterine defect was performed and the patient was admitted to intensive care for postoperative monitoring. She recovered well and was discharged free of complications. This case emphasizes the importance of early recognition and timely surgical intervention in the management of spontaneous second-trimester uterine rupture to prevent severe adverse outcomes.
妊娠中期自发性子宫破裂是一种极其罕见但危急的产科急症，会导致严重的母婴发病和死亡。一名41岁经产妇在妊娠16周时出现急性下腹痛和阴道出血。初步评估显示严重贫血和血流动力学不稳定。影像学检查显示大量腹腔积血和可能的胎盘早剥，需要紧急手术干预。急诊剖腹探查发现子宫底部破裂并有活动性出血，羊膜囊膨出。通过子宫中线垂直切口取出胎儿。对子宫缺损进行了两层修复，患者被收入重症监护病房进行术后监测。她恢复良好，无并发症出院。该病例强调了早期识别和及时手术干预在妊娠中期自发性子宫破裂管理中的重要性，以预防严重不良后果。
