Spontaneous Rupture of an Unscarred Multigravid Uterus: A Case Report

Introduction: Uterine rupture during pregnancy is a life-threatening condition that is associated with high maternal or foetal mortality. Maternal morbidity and mortality have been a major World Health Organization concern over the years, especially in sub-Saharan Africa, of which Nigeria is not exempt. Method: This paper reports a case of uterine rupture with hypovolemic shock in an unscarred uterus. A previous scarred uterus is the commonest risk factor for uterine rupture. Spontaneous rupture is a rare occurrence. Result: The patient was an unbooked 41‑year‑old gravida 5, para 4 + 0 (4 alive) at an estimated gestational age of 39 weeks + 4 days. The case was managed at our facility following a referral from a primary health centre in Abeokuta. She was referred on account of acute abdominal pain and signs and symptoms of haemorrhagic shock while in labour. Conclusion: The foetal heart rate could not be heard with the handheld Doppler and bedside ultrasound scans. A suspicion of uterine rupture, complicated by hypovolemic shock and intrauterine foetal death, was entertained. She had uterine repair and bilateral tubal ligation. Severe anaemia was corrected with appropriate pints of blood. Postpartum period was uneventful.