International Medical Case Reports Journal (Mar 2024)
Second Trimester Spontaneous Fundal Rupture of Unscarred Bicornuate Uterus in Primipara: A Case Report and Literature Review; Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia
Abstract
Hassen Mohammed Areys,1 Nour Hies Omer,1 Osman Ali Osman2 1Department of Gynecology and Obstetrics, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia; 2College of Medicine and Health Science, Jigjiga University, Jigjiga, EthiopiaCorrespondence: Hassen Mohammed Areys, Department of Gynecology and Obstetrics, College of Medicine and Health Science, Jigjiga University, P.O. Box 1020, Jigjiga, Ethiopia, Tel +251-915218641, Email [email protected] Osman Ali Osman, College of Medicine and Health Science, Jigjiga University, P.O. Box 1020, Jigjiga, Ethiopia, Tel +251-915003112, Email [email protected]; [email protected]: Primary rupture of an unscarred uterus is rare. Spontaneous rupture of an unscarred bicornuate uterus is a life-threatening obstetric emergency with high morbidity and mortality in the mother and fetus; however, it most commonly occurs in the first trimester of pregnancy.Case: A 20-year-old primigravid woman at 22 weeks of gestation, with no prior surgery, presented with severe abdominal pain, anemia, and hemodynamic instability. With a preoperative diagnosis of uterine rupture, she was transfused with three units of cross-matched whole blood and underwent emergency laparotomy. Intraoperative findings showed a ruptured bicornuate uterus and a dead fetus in the abdomen with huge hemoperitoneum. Postoperative recovery was smooth, and the patient was discharged after being counselled on family planning and subsequent pregnancy.Conclusion: A bicornuate uterus may be an independent risk factor for uterine rupture, which can occur in primigravid women at any stage of pregnancy. Each obstetrician should have a high index of suspicion for a rare condition like ruptured bicornuate uterus, especially for a pregnant woman presenting with acute abdominal pain and hemodynamic instability. Early ultrasonography plays a key role in the evaluation, follow-up, and management of these patients.Keywords: uterine rupture, bicornuate uterus, unscarred
