Delayed diagnosis of an atypical rupture of an unscarred uterus due to assisted fundal pressure: a case report.
BACKGROUND
Although rare, rupture of an unscarred uterus is one of the most dangerous obstetric complications, resulting in maternal and fetal jeopardy.


METHODS
A 30-year-old grand multiparous Turkish woman without any history of uterine surgery gave birth vaginally at 37 weeks of gestation with fundal pressure applied in the second stage of labor. Transabdominal sonography performed 32 hours after delivery due to postural hypotension and a drop in hemoglobin values in the postpartum period revealed massive intra-abdominal free fluid. On emergency laparotomy, serosal rupture of the uterus on the left posterior side was observed. She underwent a subtotal hysterectomy and did well postoperatively.


CONCLUSIONS
Postural hypotension in postpartum patients without any evident vaginal bleeding may be an early sign of possible uterine rupture, even if the vital signs are stable. Early diagnosis is important if maternal morbidity and mortality are to be decreased.
Kurdoglu
Mertihan
M
Department of Obstetrics and Gynecology, Yuzuncu Yil University School of Medicine Van Turkey. mkurdoglu@doctor.com
Kolusari
Ali
A
Yildizhan
Recep
R
Adali
Ertan
E
Sahin
Hanim Guler
HG