Article ID: HRP2022-003
The patient was a 38-year-old woman, gravida 2, para 1. Labor started at 40 weeks of gestation. Labor induction was initiated due to uterine inertia, and as fetal distress was observed, vacuum extraction was performed along with the Kristeller maneuver. Just after delivery, decreased blood pressure and hematuria were observed, and the patient was urgently transported to our hospital. Upon arrival, hematoma formation was noted in the bladder. Ultrasound on postpartum day 4 confirmed the formation of a vesicouterine fistula. The patient was diagnosed with unscarred uterine rupture and bladder rupture and underwent surgery. In this case, the external force applied to the uterus during delivery was presumed to be the cause of unscarred uterine rupture and bladder rupture. If hypotension or hematuria is observed during delivery, it is important to consider the possibility of unscarred uterine rupture and bladder rupture when managing the condition.
