A rare case of ruptured bicornuate uterus at Karnali Academy of Health Sciences
Abstract
Rupture of gravid uterus is a rare but serious obstetric complication. It is more common in multigravida or with previous uterine scar, mostly in labour. The rupture at early gestation i.e. first and second trimester is mostly associated with uterine anomalies or cornual pregnancy. The early gestation itself may pose a problem in early diagnosis. Incidence of pregnancy in rudimentary horn is 1/40,000 pregnancies1. Rupture in such cases occurs because of inability of malformed uterus to expand as a normal uterus. The rupture in rudimentary horn is likely to occur in late first trimester or even in second trimester. Rarely pregnancy can go on till late second trimester before rupturing. Chang et al reported rupture of rudimentary horn as late as 25 weeks of gestation2. A midtrimester rupture generally occurs at fundus as against lower segment rupture during labour. The haemorrhage occurring because of rupture is massive and can be life threatening, unless diagnosed and treated promptly more than other types of ruptured ectopics3, 4.
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