Precipitous delivery complicated by uterine artery laceration and uterine rupture in an unscarred uterus: A case report

Abstract

Precipitous delivery is associated with rapid cervical dilation and fetal descent. Complications of precipitous delivery can include vascular trauma, uterine rupture, and uterine artery laceration. Uterine artery laceration is a rare complication that can lead to significant postpartum hemorrhage and injury. Careful evaluation for trauma and aggressive resuscitation are critical to prevent maternal morbidity and mortality. This is a case report of a 39-year-old woman, gravida 2 para 1, at 39 weeks of gestation who delivered after induction of labor due to chronic hypertension. Her labor course was precipitous and complicated by uterine rupture and uterine artery laceration with postpartum hemorrhage that required massive transfusion, exploratory laparotomy with a supracervical hysterectomy, and interventional radiology for uterine and cervical artery embolization. This seems to be the first published case report of precipitous delivery associated with uterine artery laceration and uterine rupture. Thorough evaluation after precipitous delivery is critical to decrease maternal morbidity and mortality secondary to uterine artery injury.

Keywords

• Precipitous labor and delivery
• Uterine rupture
• Uterine artery laceration
• Postpartum hemorrhage