Rare Mid-Trimester Uterine Rupture in a 32-Year-Old Woman: A Case Report on Surgical Repair and Outcome

Abstract Mid-trimester uterine rupture is a rare but life-threatening complication, particularly in patients with a history of multiple cesarean sections. This case report details the successful management of a uterine rupture at 23 weeks gestation in a 32-year-old woman, gravida 5 para 4, with four prior cesarean sections. The patient presented to the emergency department with sudden severe abdominal pain and hemodynamic instability, including hypotension and tachycardia. Bedside ultrasound revealed significant intra-abdominal bleeding, and an emergency laparotomy confirmed a uterine rupture along the previous cesarean section scar. The rupture was surgically repaired, and the patient received multiple blood transfusions. Following close monitoring in the intensive care unit, the patient made a full recovery. This case showed the importance of early recognition of uterine rupture and the need for prompt surgical intervention, even in the second trimester, in patients with a history of uterine surgery. The case underscores the necessity of individualized management and counseling for women at risk of uterine rupture during pregnancy. Keywords: Uterine rupture, mid-trimester, cesarean section, uterine scar, emergency laparotomy, case report, hemodynamic instability, second trimester.