Rupture of the posterior cul-de-sac during spontaneous labor.
BACKGROUND
Women with genital anomalies are at increased risk of labor dysfunction. Rupture of the posterior cul-de-sac causing an intraabdominal delivery is a rare complication of labor that may be related to a congenitally atretic vagina.


METHODS
A nulliparous woman at 28 weeks of gestation with a known short vagina presented with preterm labor; her cervix could not be palpated or visualized. At cesarean delivery, the cervix was intraabdominal and the fetal head was delivered in the abdomen. A large rent in the posterior cul-de-sac required repair to restore correct anatomical positioning. The uterus was intact.


CONCLUSIONS
Rupture of the posterior cul-de-sac is a rare event that can cause significant maternal and fetal morbidity.
Young
Brett
B
From the Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Takoudes
Tamara
T
Lim
Kee-Hak
KH
Rana
Sarosh
S
D000328:Adult; D002584:Cervix Uteri / Q000002:abnormalities* / Q000000981:diagnostic imaging; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007744:Obstetric Labor Complications / Q000601:surgery*; D011247:Pregnancy; D012422:Rupture, Spontaneous; D014057:Tomography, X-Ray Computed; D014621:Vagina / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000293:injuries*