Previous Second Trimester Abortion: A risk factor for third trimester uterine rupture in three subsequent pregnancies. Report of three cases

Abstract

The authors report on three cases of uterine rupture. The first two cases occurred spontaneously and the third occurred in labour. All the patients refused voluntary termination of pregnancy before surgery. The true story was only re-constituted after surgery. Literature on spontaneous rupture of the uterus is scanty but cases occurring after hysteroscopic metroplasty,
resectroscopy for Asherman´s syndrome, hysteroscopic fundal perforation, and voluntary termination of pregnancy and in a primiparous woman are reported. Spontaneous uterine rupture though rare should always be considered in the differential diagnosis of a woman who presents with severe pain in the later half of pregnancy, with foetal loss, anaemia, with a stable or
unstable hemodynamic status and a past history of unsafe termination of a second trimester pregnancy. Though rare, this possibility should be considered in the differential diagnosis of a prolonged third stage of labour. Thorough clinical history and physical examination of patients remains the cornerstone for accurate diagnosis of uterine rupture.