To analyze the etiology and clinical characteristics of uterine rupture in pregnant women without history of cesarean section.

Retrospective analysis of the clinical data of cases of uterine rupture in patients without history of cesarean section admitted to Shenzhen Bao′an Maternal and Child Health Hospital for the past 10 years from September 2012 to September 2021, the clinical characteristics of the patient′s birth time, previous surgery, medical history, uterine rupture at the age of gestation, clinical manifestations, intraoperative observations, and maternal and infant outcomes were analyzed.

In 10 cases of uterine rupture, there were 6 multigravidas and 4 first-born women, 2 cases with history of artificial abortion, 1 case of hysteroscopic surgery, 2 cases of laparoscopic uterine fibroid removal, 2 cases of laparoscopic sutural cervical, 3 cases from ectopic pregnancy through laparoscopic treatment. uterine rupture happened at different gestational ages. 1 case occurred at gestational age of less than 24 weeks, and 5 cases of uterine rupture occurred over 34 weeks. 9 cases with abdominal pain was the main manifestation. There were 2 cases of severe abdominal pain, 1 case was found by decreased fetal motility, and 3 cases were discovered by fetal heart change at the age of pregnancy after 30 weeks. 7 cases of fetal survival were obtained. Among the 8 newborns (including twins), 2 were mildly asphyxiated and 6 were severely asphyxiated (including twins). 2 cases were stillborn and 1 case was aborted. All 10 cases of maternal uterus were effectively sutured and were discharged from the hospital smoothly after surgery.

(1) Previous history of uterine surgery is a high-risk factor for uterine rupture, but the initial signs are often not obvious, and abdominal pain is the most common manifestation, which is confused with labour pains and difficult to distinguish. (2) For women of childbearing age who have pregnancy needs, when performing gynecological surgery, they should strictly grasp the indications for surgery, carefully select the surgical method and pay attention to the surgical operation, and carry out pregnancy guidance after surgery. (3) For pregnant women with a history of gynecological surgery, it is recommended to carry previous gynecological surgery records for obstetric examination and learn more about the operation process. Be wary of the risk of uterine rupture in pregnant women with multiple histories of uterine cavity manipulation. (4) Do a good job of high-risk pregnancy supervision for pregnant women with laparoscopic cervical cerclage.