Uterine Rupture: A Case Series From a Tertiary Care Center in Northern India

Abstract

Uterine rupture is a rare, preventable catastrophic condition in obstetrics. It is associated with high fetal and maternal morbidity and mortality. Its timely diagnosis and swift management may result in better outcomes. Here, we study the presentations and outcomes of three cases of ruptured uterus in the third trimester. Three cases of uterine rupture were presented in the Department of Obstetrics & Gynaecology between the 1st of April 2022 and the 31st of March 2023 in the third trimester, at 29, 33, and 37 weeks, respectively. The mean age of the patients was 25.33 (19-29) years. All three patients had a history of scarred uterus and were diagnosed with clinical suspicion of rupture. Other symptoms were hematuria and absent fetal cardiac activity in the second case; in the third case, she had tenderness in her previous cesarean section scar. Two out of three patients required urinary bladder repair and uterus repair. All patients did well after surgery, leading to no mortality. Our case series findings suggest that the clinical presentations of ruptured uterus vary. A history of previous cesarean section, and findings suggestive of peritonitis like tachycardia, shock, pallor, and absence of an intact uterus should raise suspicion of a ruptured uterus. Searching for non-gynecological causes in such clinical presentations might delay the crucial surgical intervention that leads to mortality, morbidity, and future obstetrics function.