Spontaneous Uterine Rupture During Pregnancy

Uterine rupture is an uncommon but potentially life-threatening obstetrical emergency, occurring in 1 on 1200 to 1 on 5000 deliveries. It is more frequent in developing countries and in low-resource area. Rupture of the uterus in women without a history of cesarean section is rare, with a reported incidence of 0.02%. Incidence of uterine rupture is affected by the level of medical care and the presence of scar in the uterus. While asymptomatic uterine dehiscence rarely results in adverse fetal outcome, the complete uterine rupture with extrusion of the placenta or the fetus in the abdomen can be catastrophic. Generally, uterine rupture refers to a complete separation of all uterine layers, including the uterine serosa. It threatens the life of both the mother and fetus, with devastating maternal complications, including need for blood transfusion, intra-abdominal hemorrhage, and peripartum hysterectomy. Maternal mortality is 0.44%, and it resulted from hemorrhage, shock, sepsis, disseminated intravascular coagulation, pulmonary embolism, ileus paralyticus, peritonitis, and renal failure.