Antepartum uterine rupture at 29 weeks gestation following unilateral salpingectomy and review of literature

Antepartum uterine rupture following salpingectomy is a rare condition and is associated with high fetal and maternal mortality and morbidity. We illustrate a 33-year-old primigravida who presented with abdominal pain at 29 weeks of gestation. Her previous obstetric history included a ruptured right ectopic pregnancy for which she underwent laparoscopic salpingectomy with no breach of uterine cavity. Her antenatal care had otherwise been unremarkable. Following admission for undetectable fetal heart, ultrasound and CT demonstrated an extrauterine fetus at the right adnexal region with free fluid consistent with intra-abdominal haemorrhage. An exploratory laparotomy was performed which revealed a uterine rupture at the right cornua with the extruded fetus en caul. The fetus was delivered and the uterus repaired in three layers. The patient made an uneventful postoperative recovery and was discharged 5 days following surgery. We review the current literature including the evaluation and management of this rare condition.

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