This case highlights the importance of promptly recognizing atypical or subtle signs of uterine rupture particularly when classical symptoms are masked by epidural anesthesia. Clinicians should maintain a highly suspicion and closely monitor for alternative indicators, such as hemodynamic instability or abnormal fetal heart rate patterns. In addition, fundal pressure should be applied with caution, especially in patients with risk factors for uterine rupture such as myomectomy, to minimize the risk of adverse maternal outcomes.
Cheng et al. (Thu,) studied this question.