Abstract

Background: Uterine rupture caused by placenta accreta spectrum (PAS) is a rare, lifethreatening condition that is rarely included in the differential diagnosis of acute abdomen during the second trimester of pregnancy. Objective: To report an unusual case of spontaneous pre-labor uterine rupture at 26 weeks’ gestation presenting as acute appendicitis clinical recognition and management of this rare pregnancy complication. Clinical Case: A 32-year-old female at 26 weeks’ gestation presented with non-specific abdominal pain. Laboratory and abdominal ultrasound findings were initially interpreted as acute appendicitis, prompting diagnostic laparoscopy. Intraoperative findings showed hemoperitoneum with no appendiceal or bowel pathology. Conversion to exploratory laparotomy revealed a 3 cm defect in the lower posterior uterine wall associated with placenta increta. Conclusions: Spontaneous uterine rupture secondary to invasive placentation carries high maternal and fetal morbidity and mortality and can easily be misdiagnosed. It may occur at any gestational age, even in the absence of labor. Prompt diagnosis and immediate surgical intervention are critical to achieving favorable outcomes and preventing catastrophic events.

Keywords

uterine rupture, pregnancy, placenta accreta spectrum, placenta increta, acute abdomen