Rupture of an Unscarred Uterus in a Quadruplet Pregnancy

Abstract

In Brief BACKGROUND: Uterine rupture of an unscarred uterus is a rare complication in a quadruplet pregnancy. CASE: A 30-year-old woman, gravida 4 para 0030, with a quadruplet pregnancy and no previous uterine surgeries presented with moderate vaginal bleeding at 32 4/7 weeks of gestation. Fetal testing was reassuring, and the cervix showed no signs of preterm labor. A decision was made to proceed with cesarean delivery because of the amount of vaginal bleeding, with surgical findings of uterine rupture superior to the lower uterine segment. CONCLUSION: High-order gestations may be an independent risk factor for uterine rupture. Rupture of an unscarred uterus in a quadruplet gestation can be catastrophic and demonstrates the importance of special consideration for timing of delivery.