Spontaneous Uterine Rupture Associated with Placenta Percreta at 23 Weeks’ Gestation

Uterine rupture is a life threatening obstetrical emergency. Spontaneous uterine rupture from morbid placentattion is rare in the early second trimester of pregnancy. We are presenting the case of a 25-year-old, G2P1001, blood group B+ 23 weeks 6 days, referred to us with a 3-day history of abdominal pain, abdominal distension, and fever. She was initially managed in a different hospital for severe malaria in pregnancy. Persistence of symptoms and onset of abdominal distension, absence of fetal kicks, and hypovolemic shock prompted her referral. It was successfully managed by emergency laparotomy followed by repair of the ruptured uterus. Spontaneous uterine rupture in the second trimester can occur and present itself in an unusual way. If a gravid woman presents with hypotension, abdominal pain, and fetal distress with or without fever, the differential diagnosis should include rupture of the uterus, regardless of parity or gynecologic history.