Neglected uterine rupture… myth or reality? – A case report

Introduction

Neglected Uterine rupture in an unscarred uterus is a rare but remains the most serious and fearsome complication in obstetrics, with high maternal and fetal risks, a neglected uterine rupture is rarer but more serious affecting the maternal prognosis with a high rate of hysterectomy.

Case presentation

A 36-year-old patient, presented on postpartum day 4 a pelvic pain, physical examination finds patient in shock, Ultrasound showed an enlarged uterus with a discontinuity on the right lateral edge and abundant peritoneal fluid reaching Morison's pouch. The patient underwent a necessary total interadnexal hysterectomy due to the presence of a partial uterine necrosis.

Discussion

Neglected uterine rupture in an unscarred uterus is a rare but serious complication, occurring in approximately 1 in 10,000 pregnancies. Its incidence is higher in developing countries, largely due to socioeconomic disparities and restricted access to healthcare resources. Neglected Uterine rupture may arise from trauma or obstetric maneuvers and can occur without clear causes, as illustrated by studies finding cases of rupture without risk factors; the preferred treatment is conservative, but severe cases may necessitate a hysterectomy, especially when conservative options are not viable.

Conclusion

Neglected uterine rupture in an unscarred uterus is rare and serious, with high mortality and morbidity, often requiring rapid multidisciplinary intervention due to diagnostic delays.