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Akebom Gebremichael,1 Hale Teka,2 Kidus Kebede Abadi,3 Melkamu Siferih,4 Menberu Moges,5 Muhudin Arusi,1 Abel Shiferaw6 1Department of Obstetrics and Gynecology, St. Peter’s Specialized Hospital, Addis Ababa, Ethiopia; 2Department of Obstetrics and Gynecology, College of Health Science, Mekelle University, Mekelle, Tigray, Ethiopia; 3Department of Obstetrics and Gynecology, Riwyet Maternal and Child Health Center, Tigray, Ethiopia; 4Department of Obstetrics and Gynecology, Debre Markos University, Debre Markos, Ethiopia; 5Department of Obstetrics and Gynecology, Tayo Hospital, Baidoa, Somalia; 6Department of Obstetrics and Gynecology, Dessie Comprehensive Specialized Hospital, Dessie, EthiopiaCorrespondence: Akebom Gebremichael, Email kidanemariamakebom@gmail.comBackground: The intrauterine device is a popular and highly effective form of long-acting reversible contraception. Although generally safe, complications could happen. One of the most serious complications of intrauterine device use is uterine perforation. Risk factors for perforation include, but are not limited to, postpartum period, breastfeeding, levels of experience, and excessive force exerted during insertion. This case is significant because it demonstrates risk factors for uterine perforation, how to handle missing strings, and care in places with little resources.Case Presentation: We discuss the case of a 27-year-old black Ethiopian woman who presented with chronic pelvic pain and had a perforated intrauterine device discovered in the cul-de-sac. The device had been inserted at six weeks postpartum. The client was unable to feel the strings three months after insertion, and a wrong diagnosis of expulsion was made. After one year of insertion, the intrauterine device was located on a plain abdominal radiograph and removed via laparotomy without complications.Conclusion: Although uterine perforation is a rare complication of intrauterine device insertion, special attention should be paid to women

Adane Sisay,1 Abel Teshome,2 Esayas Regasa,1 Melkamu Siferih3 1Department of Obstetrics and Gynecology, School of Medicine, Arsi University, Assela, Ethiopia; 2Department of Obstetrics and Gynecology, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia; 3Department of Obstetrics and Gynecology, School of Medicine, Debre Markos University, Debremarkos, EthiopiaCorrespondence: Adane Sisay, Email adanenu@gmail.comBackground: Posterior uterine wall rupture is extremely uncommon in the absence of any of the commonly recognized risk factors. Even though uterine rupture is more likely in multiparous people, it cannot be believed that the uterus of a primigravid is impervious to rupture. The objective of this case report is to alert obstetricians about atypical posterior uterine wall rupture presentation in the absence of identifiable risk factors and to emphasize the worth of prompt action.Case Presentation: A 22-year-old primigravid mother with a 12 cm vertical posterior uterine wall rupture of an unscarred uterus at St. Paul’s Hospital in Ethiopia was reported to have survived an intrapartum uterine rupture during the latent early stage of labor while taking a low dose of oxytocin. The baby was saved from the abdominal cavity after an emergency laparotomy was performed. Complete hemostasis was achieved when the posterior uterine wall rupture was repaired in two layers. The patient and her baby were discharged on the fifth postoperative day smoothly.Conclusion: Posterior uterine wall rupture in a primigravid mother with an unscarred uterus is extremely rare, but a high index of suspicion should be kept in mind as expedited intervention is the only way to save the mother and fetus.Keywords: early labor, posterior uterine wall rupture, repair, unscarred uterus, Ethiopia