When the Unexpected Happens: Uterine Rupture in an Unscarred Uterus

Uterine rupture in an unscarred uterus is extremely rare, but when it occurs, it can lead to the worst maternal and neonatal outcomes due to delayed diagnosis and management. A high index of suspicion is required due to variable presentation. We present here a case of a multiparous woman at term with a spontaneous onset of labor and progression to the second stage. However, when she did not deliver even after two hours, she was referred to our center with a non-reassuring fetal heart rate. After the initial evaluation of the patient, a provisional diagnosis of uterine rupture with fetal demise was made. Emergency laparotomy was performed. A single dead fetus weighing 2.9 kg was extracted along with the placenta from the abdominal cavity. Uterine repair and bilateral tubal ligation were done. The patient was discharged on the 10th postoperative day in satisfactory condition.