Rupture of Unscarred Uterus in a Nulliparous in Unestablished Labour

This is a case report on a patient who experienced uterine rupture in her first pregnancy while not in established labour. No associated risk factors were found. Aims: To highlight course of events and promote critical thinking around the challenge of management in future pregnancies. Methods: Data was obtained directly from the medical notes. Result: Good maternal and fetal outcome was achieved following uterine rupture. Future pregnancy will have multidisciplinary planning. Various options were discussed with the couple, one of which is to manage her as an in-patient from 34weeks gestation with an elective LSCS planned at 36weeks. Discussion: There are numerous established risk factors associated with a ruptured uterus however only few causes are explained the unscarred uterine rupture in unestablished labour. Radiological investigation may be useful provided mother and fetus remain stable. If surgical repair is not suitable, it is reasonable to proceed for a hysterectomy instead of uterine repair. It remains crucial for the patient to be investigated fully when other causes are suspected e.g. connective tissue disorder. Conclusion: With the aid of a multi-disciplinary team and systematic approach, high standard of care can be provided even to the most challenging cases.