title: Spontaneous Unscarred Uterine Rupture at 15 Weeks of Pregnancy: A Case Report.
abstract: BACKGROUND
  Uterine rupture during pregnancy is a serious obstetric complication. The presence of a previous uterine scar is the most important risk factor, whereas rupture in an unscarred uterus is a rare event.
  
  
  METHODS
  A 34-year-old woman, gravida 3 para 1, presented with sudden acute hypogastric pain at 15 weeks of gestation. The patient had no history of cesarean delivery. Ultrasound scans showed an empty endometrial cavity continuing directly into the amniotic sac that developed mainly outside the uterus. Because of the ultrasound findings and the patient's progressive anemia, a laparoscopy was performed that revealed a massive hemoperitoneum caused by the rupture of the uterine fundus with exteriorization of most of the amniotic sac. Laparoscopy was converted to laparotomy, the pregnancy was removed, and the uterine disruption was repaired.
  
  
  CONCLUSIONS
  Early diagnosis and prompt treatment of uterine rupture may significantly improve prognosis. This severe obstetric complication should be considered even in early gestational age pregnancies and in the absence of known risk factors.
authors.affiliation: Department of Biomedical Clinical and Experimental Sciences, University of Florence, Florence, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Mannini
authors.affiliation: Department of Biomedical Clinical and Experimental Sciences, University of Florence, Florence, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Sorbi
authors.affiliation: Department of Biomedical Clinical and Experimental Sciences, University of Florence, Florence, Italy.
authors.forename: Viola
authors.initials: V
authors.lastname: Ghizzoni
authors.affiliation: Department of Biomedical Clinical and Experimental Sciences, University of Florence, Florence, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Masini
authors.affiliation: Department of Biomedical Clinical and Experimental Sciences, University of Florence, Florence, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Fambrini
authors.affiliation: Department of Biomedical Clinical and Experimental Sciences, University of Florence, Florence, Italy.
authors.forename: Ivo
authors.initials: I
authors.lastname: Noci
keywords: Hemoperitoneum; pregnancy; uterine rupture