SPONTANEOUS FUNDAL RUPTURE OF AN UNSCARRED UTERUS

ABSTRACT In rural India maternal mortality due to uterine rupture has been reported to be as high as 30 .1. Mostly uterine ruptures occurs in scarred uterus.In unscarred uterus rupture occurs 1 in 8000 to 1 in 15000.2 During labour rupture usually occurs in the anterior lower uterine segment .Of the total 16 rupture uterus cases in our institute in the year 2012,15 were post caesarean pregnancies . This case is rupture in fundal part of unscarred uterus. A 28 year G3 P2 L2 with previous both full term normal deliveries was reffered from a PHC in second stage of labour as abruptio placenta in view of pain abdomen, pallor,absent fetal heart sound. She was post dated. There was no history of induction,trauma. On examination she was pale, tachypnoeic,dyspnoeic, restless ,BP was stable, tachycardia was there. Superficially Palpable fetal parts and uterus lying to left iliac fossa with hemoperitoneum made a diagnosis of rupure uterus.On laparotomy there was a 10 cm tear in the fundus extending to anterior and posterior walls.Rent closure done.and Bilateral tubal sterilisation done. Three units blood transfused. Her post operative period was uneventful. She was discharged on the seventh post op day with a healed wound.