Rotura uterina espontánea en el primer trimestre del embarazo

Abstract

Uterine rupture is an uncommon obstetric event, but still potentially lethal for the mother and the fetus. It presents mainly during the second or third trimester and is associated with several risk factors, being a previous uterine scar the most important of them. Its presentation during the first trimester is exceptional, and it constitutes a medical challenge, because of its difficult differential diagnosis and controversial management. A case of a multiparous, previous triple scar woman is presented, with a spontaneous uterine rupture at 10 weeks of pregnancy. In this case the diagnosis was made during surgery, after the patient's hemodynamic decompensation. The management included primary closure of the lesion and observation; when fetal death was confirmed, dilatation and curettage of the cavity had to be performed. Because of the failure of conservative management, an obstetric hysterectomy was carried out. Histopathology reported placenta accreta.