title: Antepartum uterine rupture in a twin gestation presenting as an advanced extrauterine pregnancy in a patient with a previous lower segment Caesarean section.
abstract: We present a case of spontaneous antepartum uterine rupture through a previous lower segment Caesarean section (LSCS) scar with clinical features mimicking an advanced extrauterine pregnancy (AEUP) in a twin pregnancy at 28 weeks gestation. This report illustrates the need to consider a diagnosis of a ruptured uterus in any patient with a previous abdominal delivery who presents with mild abdominal tenderness and an ultrasonographic image suggestive of demised fetus in the intra-peritoneal cavity.
authors.affiliation: Specialist Obstetrician and Gynaecologist, Department of Obstetrics and Gynaecology, Grey's-Edendale Hospitals Complex, Pietermaritzburg and Department of Obstetrics and Gynecology, University of KwaZulu-Natal, South Africa ngenenc@gmail.com.
authors.forename: Nnabuike C
authors.initials: NC
authors.lastname: Ngene
authors.affiliation: Specialist Obstetrician and Gynaecologist, Department of Obstetrics and Gynaecology, Grey's-Edendale Hospitals Complex, Pietermaritzburg and Department of Obstetrics and Gynecology, University of KwaZulu-Natal, South Africa.
authors.forename: Thinagrin D
authors.initials: TD
authors.lastname: Naidoo
authors.affiliation: Specialist Obstetrician and Gynaecologist, Department of Obstetrics and Gynaecology, Grey's-Edendale Hospitals Complex, Pietermaritzburg and Department of Obstetrics and Gynecology, University of KwaZulu-Natal, South Africa.
authors.forename: Mokete
authors.initials: M
authors.lastname: Titus
authors.affiliation: Professor Emeritus, Women's Health and HIV Research Group, University of KwaZulu-Natal, South Africa.
authors.forename: Jagidesa
authors.initials: J
authors.lastname: Moodley
authors.affiliation: Specialist Radiologist, Department of Radiology, Grey's-Edendale Hospitals Complex, Pietermaritzburg, South Africa.
authors.forename: Shirley
authors.initials: S
authors.lastname: Craib
authors.affiliation: Registrar in Radiology, Department of Radiology, Grey's-Edendale Hospitals Complex, Pietermaritzburg, South Africa.
authors.forename: James
authors.initials: J
authors.lastname: Stutterheim
mesh_terms: D000328:Adult; D002585:Cesarean Section; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010529:Peritoneal Cavity / Q000000981:diagnostic imaging; D011247:Pregnancy; D011248:Pregnancy Complications; D011271:Pregnancy, Ectopic / Q000175:diagnosis*; D014597:Uterine Rupture / Q000175:diagnosis*
keywords: Abdominal pregnancy; Caesarean section; surgical wound dehiscence; twins; uterine rupture