Maternal Death After Uterine Rupture in an Unscarred Uterus: A Case Report

Abstract 

Spontaneous uterine rupture is a life-threatening obstetrical emergency encountered infrequently in the Emergency Department. Emergency Physicians must consider this diagnosis when presented with a pregnant patient in shock with abdominal pain. We present the case of a multigravid woman who had a spontaneous uterine rupture after induction with oxytocin, followed by a discussion of uterine rupture with special emphasis on the unscarred uterus. After the delivery, the patient was treated with fundal pressure and oxytocin due to severe vaginal hemorrhage. Despite the lack of vaginal hemorrhage after 1 h, the condition of the patient worsened. Laparotomy and a hysterectomy were performed. A parametrial hematoma about 20 cm was detected. The patient died 30 min after the operation. The treatment for intrapartum uterine rupture includes fluid resuscitation and emergency laparotomy.

Keywords: unscarred uterine rupture, maternal death, parametrial hematoma