Third trimester asymptomatic uterine rupture with ballooning of fetal membranes, case report

Abstract Uterine rupture, though uncommon, is a serious and potentially fatal obstetric complication most often occurring among women undergoing a trial of labor after Cesarean (TOLAC) and is typically accompanied by alterations in both maternal and fetal status. Asymptomatic uterine rupture prior to labor is more unusual. In this report, we detail the case of a 26-year-old woman with a history of three prior Cesarean deliveries (CDs) who, during an outpatient ultrasound, was discovered to have a pre-labor asymptomatic uterine rupture with ballooning of fetal membranes past the uterine defect into the maternal abdomen. Following discovery, she was admitted for monitoring and steroids for fetal lung maturity and was delivered without complication in the late preterm period. Current guidelines do not recommend routine ultrasound in the third trimester for use in monitoring for rupture in women with known risk factors. However, the detection of fluid in the vesicouterine space in individuals with a uterine scar should prompt consideration of a asymptomatic uterine rupture. The presence of amniotic fluid passing through a possible uterine wall defect can be verified using Doppler ultrasound technology.