Non-Traumatic Posterior Uterine Wall Rupture in an Unscarred Uterus

Abstract

Spontaneous rupture of an unscarred uterus is an exceptionally rare but life-threatening obstetric complication, particularly in women without identifiable risk factors. We report the case of a 27-year-old multigravida woman with two prior vaginal deliveries who presented in spontaneous labor at term. During active labor, she developed acute abdominal pain with fetal bradycardia, leading to an emergency laparotomy that revealed a complete rupture in the posterior uterine wall. The fetus was delivered stillborn, and the uterus was successfully repaired. No identifiable risk factor was present, and the patient had received oxytocin infusion during labor. This case underscores the importance of high clinical suspicion for uterine rupture, even in unscarred uteri, especially in the presence of abnormal fetal heart rate patterns and sudden maternal symptoms. Early diagnosis and prompt surgical intervention are critical to improve maternal outcomes in such unexpected and severe complications.