Spontaneous fundal rupture of an unscarred uterus in the second trimester of twin gestation, presenting with sepsis: a case report

This case report demonstrates that spontaneous rupture of the uterus in the second trimester can occur even in an unscarred uterus. Unusual risk factors such as a history of antepartum hemorrhage, retained placenta, manual vacuum aspiration for incomplete abortion, and use of herbal medicine might have acted together to contribute to uterine rupture in an already overdistended uterus. Clinicians should have a high index of suspicion for uterine rupture in pregnant women presenting with unusual abdominal pain during pregnancy, even in the absence of classical risk factors.