Uterine Rupture at Term Following a Prior Wedge Resection for Interstitial Pregnancy

Background: Uterine rupture following fundal surgery for interstitial pregnancy is a rare event. Literature on wedge resection for treatment of an interstitial ectopic discuss success rates in removal of the ectopic pregnancy – but a paucity of data exists on subsequent deliveries, rates of rupture, delivery modes, and timing. The timing of delivery for a mother with a prior interstitial pregnancy involving a wedge resection is controversial, and the current literature does not adequately assess the risks of continuing the pregnancy beyond 36 weeks to the patient or the fetus. Case: Our case represents a near catastrophic result after complete uterine rupture of a term fetus with a history of prior wedge resection for an interstitial pregnancy. The G2P0010 patient presented at 37 1/7 weeks gestation with complaints of severe acute abdominal pain. Upon delivery the fundus of the uterus had ruptured at the area of the prior surgical site. Conclusion: Early delivery at 36 weeks without amniocentesis for lung maturity, following the guidelines of a mother with a prior classical cesarean, will establish a safe delivery window to maximize benefit to both mother and the fetus.