Uterine rupture

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Case of about 5 mths of pregnency. H/o fall on ground - about 9 hrs before USG. C/o abdominal pain. Previous 2 LSCS.

Patient Data

Age: About 25 - 30 yrs
Gender: Female
ultrasound

Maternal liver, spleen, pancreas, gall bladder, both kidneys - Normal.

Free fluid with echoes in hepato-renal, spleno-renal, paracolic regions.

A hypoechoic avascular area abutting fundus of uterus - about 20 ( width ) x 10 ( Cranio-caudal x 4 ( antero-posterior ) cm size  --- A huge hematoma.

Single live intrauterine fetus of about 17 - 18 wks maturity corresponding to wks of amenorrhea.

Amniotic fluid is anechoic.

Anterior uterine wall was not 'normal'.

External bulge - protrusion of anterior placenta is noted  on right side.

Case Discussion

Surgical exploration - Uterine rupture from previous LSCS scar region with gross hemoperitoneum.

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