Spontaneous rupture of the uterus in the third trimester with a living fetus expelled into the abdominal cavity.

A case of rupture of the uterus during pregnancy with the living fetus expelled intra-abdominally is reported. The main symptoms were slowly increasing abdominal colicky pains. During the first five days of the hospital stay the woman's condition deteriorated and a paralytic ileus developed. The fetal lie changed between the second and third day from longitudinal to transverse and the fetus became situated at the umbilical level. At the same time the fetal heart sounds could no longer be detected and the tense uterine wall grew soft. The changed fetal lie and the paralytic ileus were radiologically substantiated. In spite of a delayed diagnosis the child and the mother were both saved. The etiology was possibly damage to the fundal wall at an earlier curettage carried out because of a spontaneous abortion. The differential diagnosis is discussed from the obstetrical as well as from the radiological and other methodological points of view.