2025 Volume 61 Issue 1 Pages 132-135
Uterine rupture without a history of uterine surgery is rare, with approximately 1 case in 15,000 incidences. However, the rupture is associated with poor perinatal outcomes and requires immediate intervention. We report a case of uterine rupture in a multiparous woman with an unscarred uterus that was successfully treated with emergency cesarean section, that resulted in the survival of both the mother and child.
The patient was a 36-year-old woman（gravida 3 para 2）. She had no particular medical history other than a vaginal delivery of twins 12 years previously. No abnormalities were observed during the pregnancy. She visited the hospital at the onset of labor on the 36th week and 4th day of pregnancy. Fetal heart rate monitoring revealed prolonged deceleration after the visit. Therefore, an emergency cesarean section was performed for fetal dysfunction. During laparotomy, the placenta was exposed in the abdominal cavity, leading to the diagnosis of complete uterine rupture. The uterus was successfully sutured and preserved. Although the neonate initially presented with severe acidosis, no neurological abnormalities were noted until 9 months of age. In this case, the patient had no significant medical history other than a previous twin pregnancy. Thus, we considered the possibility that hyperextension of the uterine myometrium associated with a twin pregnancy might have been a risk factor for uterine rupture.
