title: Severe abdominal pain exacerbated by fetal movement is an early sign of the onset of uterine rupture.
abstract: OBJECTIVE
  Uterine rupture is a rare but serious obstetric complication. However, prediction and diagnosis at an early stage remain difficult. Herein, we report a case of primary uterine rupture found earlier by a specific symptom.
  
  
  METHODS
  A 29-year-old patient was scheduled to undergo a cesarean section (CS) due to placenta previa. However, at Week 35, she began experiencing abdominal pain and uterine contractions. Subsequently, she began experiencing severe pain, which was enhanced by fetal movements. An emergency CS was performed due to continuous uncontrollable pain. When the abdominal cavity was opened, we found that much of the amniotic cavity had prolapsed outside the uterus. Despite performing total hysterectomy, both the mother and child had positive clinical courses. Uterine rupture was discovered early because of emergency CS.
  
  
  CONCLUSIONS
  This case suggests that abnormal pain exacerbated by fetal movement can be a characteristic early sign of uterine rupture.
authors.affiliation: Department of Obstetrics and Gynecology, Warabi City Hospital, 2-12-18, Kitamachi, Warabi-shi, Saitama 335-0001, Japan. Electronic address: ayatama0628@gmail.com.
authors.forename: Ayaka
authors.initials: A
authors.lastname: Kawabe
authors.affiliation: Department of Obstetrics and Gynecology, Warabi City Hospital, 2-12-18, Kitamachi, Warabi-shi, Saitama 335-0001, Japan.
authors.forename: Liangcheng
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, Warabi City Hospital, 2-12-18, Kitamachi, Warabi-shi, Saitama 335-0001, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Kikugawa
authors.affiliation: Department of Obstetrics and Gynecology, Warabi City Hospital, 2-12-18, Kitamachi, Warabi-shi, Saitama 335-0001, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Shibata
authors.affiliation: Department of Obstetrics and Gynecology, Warabi City Hospital, 2-12-18, Kitamachi, Warabi-shi, Saitama 335-0001, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kuromaki
authors.affiliation: Department of Obstetrics and Gynecology, Warabi City Hospital, 2-12-18, Kitamachi, Warabi-shi, Saitama 335-0001, Japan.
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Takagi
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology*; D000328:Adult; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods*; D005260:Female; D005324:Fetal Movement; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010147:Pain Measurement / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D012720:Severity of Illness Index; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014597:Uterine Rupture / Q000175:diagnosis*; D014621:Vagina
keywords: cesarean section; pregnancy; severe abdominal pain; uterine rupture