Rupture of the gravid (pregnant) uterus is fairly rare but accounts for 5% of maternal deaths1, and fetal mortality of up to 80%2.
Diagnosis can be difficult3. Some cases present dramatically with vaginal bleeding, shock and marked tenderness of the uterus, but shock is frequently absent, and rupture can be clinically silent.
Abdominal UltraSound (US) findings are generally indirect4 - blood or uterine contents through the myometrium (uterine wall).
Vaginal UltraSound (US) may provide more direct evidence of the defect in the uterine wall1. Computed Tomography (CT) can demonstrate the rupture but exposes the fetus to considerable radiation5. Magnetic Resonance Imaging (MRI) has similarly provided clear imaging of the defect6.
Arguably, one or more of these additional diagnostic imaging modalities should be employed if the clinical diagnosis is suspected and abdominal US is non-diagnostic.