Spontaneous uterine rupture: report of two cases.

Background: Uterine rupture is a rare entity with an incidence of 0.07% and is a cause of perinatal mortality. Dehiscence of previous uterine scar is the most important cause, but other causes have been reported such as placenta percreta. Almost 80% of uterine ruptures are spontaneous and its complications lead to an elevated mortality rate for the mother and the fetus.

Clinical Cases: Case 1. We present the case of a 28-year-old female with no previous relevant medical history. The patient was 20 weeks pregnant with a diagnosis of uterus didelphys (double uterus) with lower placental implantation with normal pregnancy evolution at the time. Evolution of her illness was with intense abdominal pain and transvaginal bleeding. Case 2. We present the case of a 20-year-old female with a history of spontaneous abortion 1 year prior. The patient denied pregnancy and even reported her last menstruation date on 3/23/09. She began with sudden abdominal pain associated with two episodes of diarrhea, dizziness and fainting.

Conclusion: Uterine rupture is a rare clinical entity with an elevated perinatal mortality. Clinical suspicion is of vital important for early diagnosis and timely treatment.