title: Successful outcome in pregnancy complicated by prior uterine rupture: a report of two cases.
abstract: BACKGROUND
  Rupture of the uterus, especially in a scarred uterus, intrapartum is well known. The risk of uterine rupture in women with a previous lower segment caesarean section is 0.2-1.5%, whereas in an unscarred uterus it is extremely rare.
  
  
  METHODS
  Case 1 A 26-year-old woman in her third pregnancy was referred at 16 weeks from a community hospital. She had a history of uterine perforation at the fundus in her first pregnancy during a dilatation and curettage requiring laparotomy and repair. In her second pregnancy, fetal death had occurred in the second trimester. She conceived subsequently and in her third pregnancy, the risk of silent rupture of uterus was explained, but the couple opted for continuation of this pregnancy. Case 2 A 25-year-old woman in her third pregnancy was referred. In her first pregnancy, she had a septic abortion during the fifth month of pregnancy. Two years later, she presented at 16 weeks gestation with a severe abdominal pain. An ultrasound/MRI revealed a uterine wall defect with an empty uterus, fetus lying outside the uterine cavity with moderate free fluid. In her third pregnancy, 18 months later, at 10 weeks gestation an ultrasound revealed a single live intrauterine pregnancy with an indistinct thinning and sacculation of the fundo-posterior uterine wall.
  
  
  CONCLUSIONS
  With increasing caesarean rates, every obstetrician is bound to face the challenge of this life-threatening obstetric hazard and must be prepared to handle this emergency with an expeditious recourse to laparotomy.
authors.affiliation: Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, 110 029, India. dpk_deka@yahoo.com
authors.forename: Deepika
authors.initials: D
authors.lastname: Deka
authors.forename: Anupama
authors.initials: A
authors.lastname: Bahadur
authors.forename: Vatsla
authors.initials: V
authors.lastname: Dadhwal
authors.forename: Sumana
authors.initials: S
authors.lastname: Gurunath
authors.forename: Arvind
authors.initials: A
authors.lastname: Vaid
mesh_terms: D000328:Adult; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007231:Infant, Newborn; D008297:Male; D010921:Placenta Accreta; D011247:Pregnancy; D011256:Pregnancy Outcome; D014597:Uterine Rupture