A CASE REPORT ON AN ATYPICAL UTERINE RUPTURE - RUPTURE DURING MISCARRIAGE MANAGEMENT.

Background: Uterine rupture is a severe obstetric complication traditionally associated with a history of cesarean section or other factors causing uterine scarring. However, instances of atypical uterine rupture in patients have been reported.This case report presents an atypical example of uterine rupture in a patient with no known risk factors, emphasizing the need for high suspicion of uterine rupture even in the absence of risk factors. Case presentation: The case discusses a gravida 3, para 2 female with no significant history, except for treatment for cervical intraepithelial neoplasia. No history of cesarean section or uterine scarring.They were presented with light vaginal bleeding and later diagnosed with amiscarriage at 20+1 weeks of gestation. Managed with misoprostol per trust guidelines, the patient developed severe pain, signs of sepsis, and shock. An ultrasound revealed a heterogeneous mass in the lower uterine segment and free fluid in the pelvis.ACT scan confirmed a ruptured uterus with the fetus and placenta lying anteriorly and hemoperitoneum present. A laparotomy was performed under general anesthesia and the uterus was repaired. Post-operatively, the patient developed ileus and a pulmonary embolism,whichwere treated,leading to a gradualrecovery.Conclusion:This atypical case of uterine rupture highlights the need to maintain a high level of suspicion for uterine rupture, even in the absence of traditional risk factors. It also underscores the importance of careful patient management during labor induction with misoprostol, especially when complications arise. This case reminds clinicians to consider all possible diagnoses when a patient's condition deteriorates, even in the absence of conventional risk factors. More research is needed on theuseoflabour-inducingdrugs,particularlymisoprostol,inthemanagementofintrauterine fetaldeath