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Review
. 2024 Jan 6;18(1):5.
doi: 10.1186/s13256-023-04318-w.

Uterine rupture in the first trimester: a case report and review of the literature

Steve Kyende Mutiso  1 , Felix Mwembi Oindi  2 , Debbie Muthoni Mundia  2
Affiliations
Review

Uterine rupture in the first trimester: a case report and review of the literature

Steve Kyende Mutiso et al. J Med Case Rep. .

Abstract

Background: Uterine rupture is a rare complication that can occur in the first trimester of pregnancy. It can lead to serious maternal morbidity or mortality, which is mostly due to catastrophic bleeding. First trimester uterine rupture is rare; hence, diagnosis can be challenging as it may be confused with other causes of early pregnancy bleeding such as an ectopic pregnancy. We present a case of first trimester scar dehiscence and conduct a literature review of this rare condition.

Case presentation: A 39-year-old African patient with four previous hysterotomy scars presented with severe lower abdominal pain at 11 weeks of gestation. She had two previous histories of third trimester uterine rupture in previous pregnancies with subsequent hysterotomies and repair. She underwent a diagnostic laparoscopy that confirmed the diagnosis of a 10 cm anterior wall uterine rupture. A laparotomy and repair of the rupture was subsequently done.

Conclusion: In conclusion, the case presented adds to the body of evidence of uterine scar dehiscence in the first trimester. The risk factors, clinical presentation, diagnostic imaging, and management outlined may help in early identification and management of this rare but life threatening condition.

Keywords: Complications; First trimester; Outcome; Uterine dehiscence.

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Conflict of interest statement

The authors have no competing interests to declare with regards to the present study.

Figures

Fig. 1
Fig. 1
Free fluid in the pouch of Douglas. FF, free fluid; POD, pouch of Douglas
Fig. 2
Fig. 2
Intrauterine pregnancy with cardiac activity
Fig. 3
Fig. 3
Laparascopic view showing the uterine rupture site and hamoperitoneum
Fig. 4
Fig. 4
The gestational sac protruding
Fig. 5
Fig. 5
The placenta being delivered
Fig. 6
Fig. 6
Uterine rupture approximately 10 cm in length
Fig. 7
Fig. 7
The uterus after repair
See this image and copyright information in PMC

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