title: Third-trimester uterine rupture without previous cesarean: a case series and review of the literature.
abstract: We sought to describe a case series and literature review of uterine rupture in the absence of a previous cesarean delivery. In addition to four cases in our institution, a search of the literature from 1994 to 2008 identified cases of uterine rupture unrelated to a prior cesarean. Uterine rupture in the absence of a previous cesarean may be associated with remote unrecognized uterine perforation, myomectomy, thermal injury, and obstructed labor. Such ruptures may occur before or after labor onset, at term or preterm, and with or without nonreassuring fetal heart rate patterns. Spontaneous uterine rupture is associated with highly variable and nonspecific maternal complaints and fetal status, requiring a high index of diagnostic suspicion.
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Maine Medical Center, Portland, Maine, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Dow
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Wax
authors.forename: Michael G
authors.initials: MG
authors.lastname: Pinette
authors.forename: Jacquelyn
authors.initials: J
authors.lastname: Blackstone
authors.forename: Angelina
authors.initials: A
authors.lastname: Cartin
mesh_terms: D002585:Cesarean Section; D005260:Female; D005865:Gestational Age; D006801:Humans; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000517:prevention & control; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011263:Pregnancy Trimester, Third; D018570:Risk Assessment; D012307:Risk Factors; D014597:Uterine Rupture / Q000453:epidemiology* / Q000517:prevention & control