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Abstract

Uterine rupture in an unscarred uterus is an obstetric emergency that can lead to considerable morbidity and mortality for both mother and fetus. It is uncommon yet fatal. This case report presents a 39-year-old woman, gravida 4 para 3+0, with no prior history of uterine surgery or complications during her antenatal visits. At 38 weeks of gestation she delivered a healthy neonate via spontaneous vaginal delivery. Following the delivery, she suffered from massive postpartum haemorrhage and was unresponsive to initial management, including the use of uterotonics, balloon tamponade, and resuscitation. While transferring her to a tertiary care facility, the posterior uterine rupture was identified, and she underwent emergency surgical intervention. After resuscitation with fluids and blood products, the patient was monitored closely and underwent uterine repair. The case underscores the importance of considering uterine rupture as a possible cause of persistent postpartum bleeding, even without a prior cesarean section history. It highlights the need for prompt diagnosis, surgical intervention, and multidisciplinary care to optimize maternal health in such rare but high-risk case scenarios.