Fatal consequences of uterine rupture in late pregnancy.

Abstract

Uterine rupture in pregnancy belongs to acute conditions in gynaecology and obstetrics. It is a life-threatening complication for both mother and foetus. The occurrence of fatal consequences in developed countries is very rare. The causes of rupture include scarring after the caesarean section, fibroid enucleation, rough curettage, muscular insufficiency in uterine developmental defects, uterine wall damage due to inflammation, uterine hypoplasia, elevated intrauterine pressure during contraction, cephalopelvic disproportion, previous fibroid, prostaglandin or oxytocin administration, etc. This paper aims at the presentation of a 32-year-old woman who died in the 35th week of gestation due to uterine rupture at home despite having been transferred to a medical facility at the terminal stage of life. At the autopsy, a complete rupture of the posterior uterine wall with bleeding into the abdominal cavity and an amniotic sac with a male foetus in the abdominal cavity was found. There were no signs of the effects of violence detected. Histopathological examination revealed no pathological changes in the uterine muscle. The immediate cause of maternal death was a haemorrhagic shock. The autopsy of the foetus revealed signs of asphyxia. The immediate cause of foetal death was intrauterine asphyxia. In this case, forensic expertise ruled out the violent causes of uterine rupture and deaths in terms of mechanical and chemical factors and supported to make a diagnosis of spontaneous rupture.