Abstract :Background: Uterine rupture is an obstetric emergency with potential for catastrophic maternal
and fetal outcomes. Uterine instrumentation has not been commonly thought to be associated with
uterine rupture.
Case Presentation: A 31 year old, gravida 21, para 3, 0, 17, 3 underwent induction of labor at 40
6/7 weeks. She had no prior cesarean deliveries, two prior spontaneous abortions, and fifteen prior
surgical terminations of pregnancy in the first trimester. Her active phase of labor was complicated
by deterioration of the fetal heart tracing. She underwent vacuum assisted vaginal delivery followed
by a postpartum hemorrhage. Bimanual examination revealed a lower uterine segment defect with
palpable intra-abdominal contents. She underwent exploratory laparotomy and supracervical
hysterectomy.
Conclusion: A high index of suspicion and early diagnosis are paramount to the management
of uterine rupture. Uterine rupture should be considered in patients with a history of uterine
instrumentations.