Uterine rupture is a life-threatening obstetric complication. The purpose of this study was to investigate the epidemiological features, maternal and foetal prognosis and different treatment options for uterine rupture in healthy and scarred uteri. We conducted a retrospective monocentric descriptive and analytical study of 60 cases of uterine rupture collected in the Department of Gynaecology-Obstetrics of the Center of Maternity and Neonatology, Monastir, from 2017 to 2021. Patients were classified according to the presence or absence of a uterine scar. Sixty patients were enrolled in the study. The majority of cases of rupture occurred in patients with scarred uterus (n=55). The most common clinical sign was abnormal foetal heart rate. No maternal deaths were recorded and perinatal mortality rate was 11%. Mean BMI, fetal macrosomia rate and mean parity were significantly higher in the healthy uterus group than in the scarred uterus group (p=0.033, 0.018, and 0.013, respectively). The maternal complications studied (post-partum haemorrhage, hysterectomy, blood transfusion, prolonged hospitalisation) were significantly more frequent in patients with unscarred uterine rupture (p=0.039; p=0.032; p=0.009; p=0.025 respectively). Uterine rupture is a life-threatening obstetrical event for the foetus and the mother. Fetal heart rate abnormality is the most common sign associated with uterine rupture. Management is based on conservative treatment in most cases. Patients with scarred uterus have a better prognosis.

Uterine rupture is a rare but critical obstetric complication that demands a swift and decisive intervention to ensure the well-being of the mother and fetus. We present a case report detailing the surgical management of a bizarre uterine rupture in a multigravida female with two previous vaginal deliveries and a previously unscarred uterus. This case highlights the challenges of treating and diagnosing, particularly in the Indian setting, an antenatally unregistered patient with rare obstetrical complications. Emphasizing the clinical challenges faced and the multidisciplinary approach employed for optimal outcomes, this report underscores the importance of a high degree of suspicion, early diagnosis, timely intervention, and comprehensive intraoperative and postoperative care in addressing this rare obstetric catastrophic event. This article\'s main focus is multicentric, aiming to showcase the obstacles to maintaining low maternal mortality and morbidity, the presence of inadequate awareness in society, and the importance of multimodal treatment and planning.

Spontaneous uterine rupture in unscarred uteri complicated by pulmonary emboli is a rare event with major maternal morbidity and mortality. This is a case of a 32-year-old woman, G1P0, at term, with no pertinent past medical/surgical history, who underwent an emergency cesarean delivery for failed induction of labor complicated by uterine rupture. Post-operatively, the patient was tachycardic and hypoxic. CT arteriogram revealed massive bilateral pulmonary emboli, and she was transferred for specialist care. An emergency pulmonary embolectomy and implantation of an extracorporeal right ventricular assist device were performed. Once the patient was clinically stable, an evaluation for thrombophilias and collagen disorders was done, and was positive for a variant of unknown significance in the ELN gene (c.205G > C). This case report highlights a potential connection between uterine ruptures, hemorrhage, and multiple, large pulmonary emboli. The authors propose a multidisciplinary discussion and evaluation to identify risk factors and biologic causes for these rare but life-threatening complications.

UNASSIGNED: Uterine rupture is a rare obstetrical and surgical emergency but is often associated with a catastrophic obstetric complication. Traditionally, unscarred uteri without risk factors are considered immune to rupture and information about its risk factors is only few due to its rarity. Complementary and alternative medicine is commonly used in pregnant woman in southeast Asian countries such as Indonesia, however information regarding its toxicity due to irrational use is few. This case report presents a G2P1A0 35-year-old woman with acute abdomen with spontaneous unscarred uterine rupture >15 cm after continuously consuming herbal water made of Kacip Fatimah leaves in boiling water.
UNASSIGNED: A 35-year-old pregnant woman was referred to hospital due to abdominal discomfort 3 hours before admission due to suspicion of intrauterine fetal death. She drank the extracted herbal water to help her when the labor comes, which was made from boiled water with rumput Fatimah from her neighbor\'s house. Then, she was diagnosed with G2P1A0 parturient aterm latent phase; acute abdomen due to suspicion of placentae abruption dd/ ruptur uteri; and Intrauterine Fetal Death. Exploratory laparotomy was decided due to acute abdominal pain, and during the procedure the operator decided to do subtotal hysterectomy on the patient. The operator found her uterine was already ruptured, approximately 15-18 cm and the placentae was located outside of the uterus.
UNASSIGNED: This case suggest that rational usage of herbal medicine must be implemented to avoid unwanted complication.

UNASSIGNED: Posterior uterine wall rupture is extremely uncommon in the absence of any of the commonly recognized risk factors. Even though uterine rupture is more likely in multiparous people, it cannot be believed that the uterus of a primigravid is impervious to rupture. The objective of this case report is to alert obstetricians about atypical posterior uterine wall rupture presentation in the absence of identifiable risk factors and to emphasize the worth of prompt action.
UNASSIGNED: A 22-year-old primigravid mother with a 12 cm vertical posterior uterine wall rupture of an unscarred uterus at St. Paul\'s Hospital in Ethiopia was reported to have survived an intrapartum uterine rupture during the latent early stage of labor while taking a low dose of oxytocin. The baby was saved from the abdominal cavity after an emergency laparotomy was performed. Complete hemostasis was achieved when the posterior uterine wall rupture was repaired in two layers. The patient and her baby were discharged on the fifth postoperative day smoothly.
UNASSIGNED: Posterior uterine wall rupture in a primigravid mother with an unscarred uterus is extremely rare, but a high index of suspicion should be kept in mind as expedited intervention is the only way to save the mother and fetus.

Spontaneous uterine rupture in an unscarred uterus is very rare. It is found to be rarer after in-vitro fertilization. It is associated with significant morbidity and mortality if not diagnosed and treated promptly.
UNASSIGNED: Thirty three years female with twin pregnancy following in-vitro fertilization after 11 years of marriage presented to emergency department with lower abdominal pain at 36 weeks 3 days of gestation and was planned for emergency caesarean section for precious twin pregnancy in labour.
UNASSIGNED: She was vitally stable and on palpation of abdomen, there was generalized tenderness along with guarding. All the investigations were within normal limits.
UNASSIGNED: Emergency caesarean section was performed under subarachnoid block which revealed a 6×2 cm fundal uterine rupture with no active bleeding which was repaired in layers. The babies were extracted with a lower uterine segment incision. First twin cried immediately after birth while the second one needed resuscitation and mechanical ventilation due to perinatal asphyxia.
UNASSIGNED: Even though rare in a previously unscarred uterus, uterine rupture can present in different forms and thus, requires vigilant evaluation of the patient and prompt intervention to avoid significant maternal or foetal morbidity and mortality.

A silent rupture of an unscarred uterus is a rare phenomenon. Accidental diagnosis of silent rupture during sterilization procedure in a previous vaginal delivery is rarely reported. We present a case of uterine rupture in an unscarred uterus in a 40-year-old gravida 10 para 9 with intrauterine fetal demise terminated with prostaglandin E2. She was asymptomatic and hemodynamically stable. Hemoperitoneum was observed during a tubal ligation procedure performed on the third day after the abortion. A right-sided broad ligament hematoma was noticed, and surgical treatment was initiated when the patient\'s condition clinically deteriorated during the operation. Our article aims to raise obstetricians\' awareness of an important causative factor of hemoperitoneum found during postpartum tubal ligation surgery.

Rupture of the uterus is a deadly obstetric complication. Its occurrence is uncommon and much less common in the second trimester. Given that the mother and fetus are in danger, it is a catastrophe for both. The incidence has increased in recent years as the cesarean section rate has increased, but in developing nations, multiparity and the inappropriate use of uterotonics are more common. This potentially disastrous event may have a vague initial presentation. Here forth, we present a case with solitary right lateral wall uterine rupture covering the entire length of the uterus, the fetus and placenta enclosed in between the broad ligament leaves, most likely due to injudicious misoprostol use at a private health care center superimposed on multiparity, and a literature review. As far as we know, this is the first instance of an isolated right lateral uterine wall rupture sparing the lower segment and, with the fetus trapped between the broad ligaments simulating abdominal pregnancy.

Morbidly adherent placenta is a spectrum of obstetric complication which is life threatening to both mother and fetus. Congenital uterine malformation is a rare cause of such a condition. Here we present a case report of placenta increta in bicornute, unscarred uterus. An 18 year old para1+1 presented in emergency with history of vaginal delivery of still birth baby followed by vaginal bleeding with retained placenta. Her Examination under anaesthesia and failed attempt of manual removal of the placenta performed in emergency followed by Doppler ultrasound showed a bicornuate uterus with possibility of placenta increta, later this diagnosis was confirmed on magnetic resonance imaging (MRI). Patient managed with injection methotrexate along with folinic acid followed by removal of placenta under general anesthesia, hence we preserved her fertility. The aim of this report is to emphasize the importance of this rare but a possible association of nonscar and malformed uterus with spectrum of abnormal placentation. Obstetrician should run a full set of investigations in such cases to prevent maternal and fetal mortality and morbidity.

A 34-year-old gravida 2, para 1 woman at 37+4 weeks of pregnancy presented with abdominal pain. She had no medical history. Complete examination was unremarkable. After hours of monitoring, the patient abruptly deteriorated. An emergency cesarean delivery revealed a ruptured uterus with significant issues. Cautious monitoring is essential for such patients with atypical pain.