Asymptomatic Uterine Rupture at 20 Weeks of Gestation: A Case Report and Review of Literature.

Introduction: Second-trimester ruptures are mainly associated with trauma, induced pregnancy terminations in scarred uterus, or complications. Risk of uterine rupture is specifically increased with the use of prostaglandin, notably Misoprostol, for the induction of labor in women with a history of cesarean section and uterine scar. Presentation of Case: A 32-year-old female patient at 20 weeks and 3 days of gestation and intrauterine fetal demise (IUFD), with a history of C-sections, presented to our care initially for administration of Misoprostol for management of IUFD, and was sent home on Misoprostol due to slow response at the hospital. Two days later, the patient was diagnosed with uterine rupture on ultrasound during follow-up in the clinic. The patient, asymptomatic, was sent to the hospital for an emergency laparotomy. Conclusion: Second-trimester ruptures are a rare occurrence but are mainly seen in patients with induction of labor with prostaglandins in the case of IUFD or abortions. Our patient had a second-trimester rupture with no associated symptoms, which raises concern about diagnosing these ruptures before instability happens.