The atypical presentation of uterine scar rupture covered by hematoma – A case report with a favorable prognosis

Uterine rupture is a rare but life-threatening obstetric emergency, particularly in women with a history of previous cesarean sections. We present a unique case of uterine scar rupture at 36 weeks of gestation, where the rupture was covered by a hematoma, leading to a favorable outcome for both the mother and the baby. A 35-year-old woman with a history of three prior cesarean sections presented with mild lower abdominal pain and decreased fetal movements. Ultrasound revealed a hematoma in the lower uterine segment near the previous scar, raising suspicion of uterine rupture. An emergency cesarean section confirmed a 5 cm rupture in the lower uterine segment, which was sealed by a large hematoma, limiting significant hemorrhage. The uterine defect was repaired, and both the mother and baby recovered without complications. This case underscores the importance of timely diagnosis and surgical intervention in uterine rupture cases and demonstrates that a hematoma covering the rupture can delay catastrophic outcomes, allowing for a more favorable prognosis.