Journal of obstetrics and women's diseasesJournal of obstetrics and women's diseases1684-04611683-9366Eco-Vector6347110.17816/JOWD63471Research ArticleA clinical case of the uterine complete rupture along with the previous scar during pregnancy with atypical clinical featuresMochalovaMarina N.<p>MD, Cand. Sci. (Med.), Assistant Professor</p>marina.mochalova@gmail.comhttps://orcid.org/0000-0002-5941-0181MudrovViktor A.<p>MD, Cand. Sci. (Med.), Assistant Professor</p>mudrov_viktor@mail.ruhttps://orcid.org/0000-0002-5961-5400AlexeyevaAnastasia Yu.<p>MD</p>mironenkoanastasia4@gmail.ruhttps://orcid.org/0000-0001-5061-8026KuzminaLyubov A.<p>MD</p>prostopochta1804@mail.ruhttps://orcid.org/0000-0003-2035-7966Chita State Medical AcademyRegional Clinical Hospital021120217051411461703202115092021Copyright © 2021, Eсо-Vector2021<p>This article presents an unusual case of rupture of the scarred uterus at 36-37 weeks of gestation. The patient presented with pain in the pubic and hip joint area, growing stronger while her walking, seated and changing position. No clinical manifestations of hemorrhagic shock were observed. External obstetric examination revealed a normotonic uterus and satisfactory fetus condition. Provocation tests were conducted to exclude subluxation of the pubic joint. Pubic symphysis diastasis palpation, long dorsal sacroiliac ligament palpation, P4 test, Patricks test, and the modified Trendelenburg test were negative. Pelvic examination revealed sharp pain in lower uterus segment. Ultrasound scan revealed deformation and thinning of the scar up to 1 mm, and no abnormalities in pubic symphysis. A threatening uterine rupture was diagnosed, and emergency cesarean section was performed. Intraoperative examination showed that the scar located in the lower segment consisted of connective tissue. In addition, there was a 4 5 cm scar defect with the overlying amniotic sac, no hemorrhage being noted. After removing the fetus, scar excision was performed. The uterine defect was repaired with a double layer running-locking suture. The patient was discharged from hospital on day 5 of postpartum period. The infant was exposed in the neonatal intensive care unit to provide an early developmental care.</p>spontaneous uterine ruptureuterine scarclinical manifestationshistopathic uterine ruptureспонтанный разрыв маткирубец на маткеклиническая картина разрыва матки во время беременностигистопатический разрыв матки[Olenev AS, Vuchenovich YuD, Novikova VA, Radzinsky VE. Uterine rupture and risk of near miss. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie. 2019;7(3):55−63. (In Russ.). DOI: 10.24411/2303-9698-2019-13008][Kurmanbaev TE, Tukhvatullina LM, Khayrullina EA, et al. Case of uterine scar rupture in the second trimester of pregnancy after preceding caesarean section. Kazan medical journal. 2018;99(1):144−148. (In Russ.). DOI: 10.17816/KMJ2018-144][Barger MK, Nannini A, Weiss J, et al. Severe maternal and perinatal outcomes from uterine rupture among women at term with a trial of labor. J Perinatol. 2012;32(11):837−843. DOI: 10.1038/jp.2012.2][Akusherstvo: uchebnik. Ed. by Radzinskiy VE, Fuks AM. Moscow: GEOTAR-Media; 2016. (In Russ.)][Harper LM, Cahill AG, Roehl KA, et al. The pattern of labor preceding uterine rupture. Am J Obstet Gynecol. 2012;207(3):210.e1−210.e2106. DOI: 10.1016/j.ajog.2012.06.028][Baskett TF, Kalder JeA. Operativnoe akusherstvo Manro Kerra. Moscow: Logosfera; 2015. (In Russ.)][Barinov AN, Sergienko DA. Fenomen tazovoj boli glazami nevrologa. Nervnye bolezni. 2015;(2):20−27. (In Russ.)]