Diagnosis and Management of a Postpartum Uterine Rupture following Caesarean Section

An unusual case of an incidental sonographic finding of a large uterine rupture after caesarean section (CS) is presented. The patient had a history of silent uterine rupture diagnosed during her third CS four years ago. Four years after the CS the patient presented to her gynecologist with chronic lower abdominal pain. During ultrasound imaging large inhomogeneous tumor presented in the area of the former CS scar protruding through the anterior uterine wall. Magnetic resonance imaging (MRI) confirmed an old large defect of the anterior uterine wall with hematoma. A surgical reconstruction of the uterus was impossible unfortunately, so a hysterectomy had to be performed. A caesarean scar defect with uterine rupture is an important obstetric complication and an under recognized cause for chronic lower abdominal pain in premenopausal women.