A Rare Case of Sonographically Detected Silent Rupture of a Gravid Uterus With Expulsion of a Complete Fetus and an Intact Amniotic Sac

罕见病例:超声检查发现妊娠子宫无症状破裂,完整胎儿娩出,羊膜囊完整

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Abstract

Uterine rupture is an infrequent complication that can threaten the survival of both mother and growing fetus. Prelabor silent uterine rupture with expulsion of an intact amniotic sac into the abdominal cavity is very rare. We report such a case of a 23-year-old pregnant woman who presented for a routine antenatal ultrasound scan in her third trimester. Her previous scan, done elsewhere at 23 weeks of gestation, had shown a live intrauterine fetus. Our antenatal USG scan showed a full-thickness defect in the lower uterine wall with placental herniation plugging the defect and the rest of the products of conception (i.e., a nonviable fetus with an intact amniotic sac) in the abdominal cavity. The patient underwent surgery, which confirmed our findings. Diagnosis of the entity is made intraoperatively unless a thorough antenatal USG examination is done. Early diagnosis and timely management are critical for preserving life and fertility.

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