Traumatic Uterine Rupture Sealed by a Hematoma:Rare Case of Maternal and Neonatal Survival
Authors:   Gynaecology obstetrics, Department of Obstetrics and Gynecology, Ibn El Jazzar University Hospital, Kairouan, Tunisia, Kairouan, Tunisia., Farhat Imen Ben , Aidi Hadhemi ,   Gynaecology obstetrics, Department of Obstetrics and Gynecology, Ibn El Jazzar University Hospital, Kairouan, Tunisia, Kairouan, Tunisia., Knaz Samar ,   Gynaecology obstetrics, Department of Obstetrics and Gynecology, Ibn El Jazzar University Hospital, Kairouan, Tunisia, Kairouan, Tunisia., Chihaoui Rania ,   Gynaecology obstetrics, Department of Obstetrics and Gynecology, Ibn El Jazzar University Hospital, Kairouan, Tunisia, Kairouan, Tunisia., Miladi Marwa ,   Gynaecology obstetrics, Department of Obstetrics and Gynecology, Ibn El Jazzar University Hospital, Kairouan, Tunisia, Kairouan, Tunisia., Khalfaoui Aymen ,   Gynaecology obstetrics, Department of Obstetrics and Gynecology, Ibn El Jazzar University Hospital, Kairouan, Tunisia, Kairouan, Tunisia., Dhouibi Mariem ,   Gynaecology obstetrics, Department of Obstetrics and Gynecology, Ibn El Jazzar University Hospital, Kairouan, Tunisia, Kairouan, Tunisia., Sallami Arige ,   Gynaecology obstetrics, Department of Obstetrics and Gynecology, Ibn El Jazzar University Hospital, Kairouan, Tunisia, Kairouan, Tunisia., Braiek Balsam ,   Gynaecology obstetrics, Department of Obstetrics and Gynecology, Ibn El Jazzar University Hospital, Kairouan, Tunisia, Kairouan, Tunisia., Romdhani Maryem ,   Gynaecology obstetrics, Department of Obstetrics and Gynecology, Ibn El Jazzar University Hospital, Kairouan, Tunisia, Kairouan, Tunisia., ghades Sana ,   Gynaecology obstetrics, Department of Obstetrics and Gynecology, Ibn El Jazzar University Hospital, Kairouan, Tunisia, Kairouan, Tunisia., Fatnassi Ridha ,   Gynaecology obstetrics, Department of Obstetrics and Gynecology, Ibn El Jazzar University Hospital, Kairouan, Tunisia, Kairouan, Tunisia.
Published: November 2024

Background: Uterine rupture is a rare but severe obstetric complication associated with high maternal and neonatal mortality. It typically requires immediate intervention to prevent significant maternal and fetal morbidity. The condition is more common in women with previous cesarean sections but can also occur spontaneously or after trauma, as in the case described here. Early diagnosis and prompt surgical management are essential to minimize risks and ensure favorable outcomes.

Case Presentation: We report an unusual case of complete uterine rupture in a 38-year-old patient at 38 weeks of gestation. The rupture occurred several hours after a minor trauma. The patient presented to the emergency department with persistent pelvic pain and vaginal bleeding, symptoms that had initially been neglected. Clinical and fetal assessment revealed fetal heart decelerations, prompting an emergency cesarean section. During the surgery, a complete uterine rupture was discovered, sealed by a 300 cc hematoma. The newborn displayed mild respiratory distress but showed improvement post-delivery, while the mother’s recovery was also successful following uterine repair.

Conclusion: This case underscores the importance of clinical vigilance in monitoring pregnant patients, particularly those with a history of cesarean section. It highlights the potential for temporary stabilization of uterine rupture through hematoma formation, which can provide a critical window for timely intervention. The favorable outcomes in both the mother and infant demonstrate the importance of prompt management in obstetric emergencies.