Rotura vesicouterina posparto eutócico en ausencia de cirugía uterina previa. Caso clínico y revisión bibliográfica

Abstract

BACKGROUND: Uterine rupture is an unpredictable and infrequent obstetric emer- gency which is associated to a high maternal and perinatal morbi-mortality. The most important risk factor is prior uterine surgery. OBJECTIVE: To report a complete vesicouterine rupture case occurred after a vaginal delivery without prior uterine surgery. It is intended to review the risk factors, the suspicious signs and symptoms, as well as the optimal management and maternal and perinatal prognosis of uterine rupture in unscarred uterus. CLINICAL CASE: A 35-year-old woman, para 2 with neither uterine surgical pro- cedures nor other medical records, had a normoevolutive pregnancy and required induction of labour with a dinoprostone vaginal slow-release system (10 mg) due to late-term pregnancy at 41 +5 weeks. The labor progressed normally, ending in a vaginal delivery. After 1h postpartum, the patient started with a progressive abdominal pain and haematuria. The computerized tomography scan showed a severe hemoperito-neum and suggested the presence of a vesical continuity solution with disfiguration of the of a subtotal Diagnostic suspicion, even in the absence of risk factors, and early diagnosis and management are crucial to decrease it.