Uterine rupture in a primigravida presenting as an acute abdomen post delivery: a case report.

BACKGROUND

Spontaneous rupture of the uterus in primigravida is a rare event reported in the literature. Rupture of the uterus usually presents as an acute life-threatening condition with symptoms and signs that makes diagnosis relatively easy particularly when there is history of obstructed labour and other risk factors. A case of uterine rupture in a primigravida with clinical signs evolving insidiously post delivery is being reported.

METHOD: A review of the case record of a primigravida who developed acute abdomen post delivery and the relevant literature search was done with pubmed using, uterus, rupture, primigravida, oxytocin use, and vaginal delivery as key words.

RESULT: A 22-year old primigravida who had spontaneous vaginal delivery developed acute abdomen post delivery subsequently had a laparotomy for suspected intra abdominal abscess and was found to have ruptured uterus. Repair of the uterus was done and post operative recovery was uneventful. Subsequent history from the patient revealed previous termination of a 5 month pregnancy 3 years before.

CONCLUSION

This report highlights the need to suspect the possibility of uterine rupture as a differential diagnosis of acute abdomen post delivery particularly if there is past history of manipulations involving the uterus.