Successful repair of spontaneous uterine rupture in the second trimester of pregnancy with progression to live birth.

Objectives: Uterine rupture before the onset of labor is a rare but life-threatening obstetric emergency. This condition carries a high risk of maternal and fetal morbidity and mortality and requires prompt and careful management. Case presentation: A 26-year-old woman, gravida 3 and parity 2, was admitted to the gynecology department with complaints of abdominal pain in her 23rd week of pregnancy. During evaluation, a decrease in hemoglobin levels was noted, and abdominal MRI revealed uterine rupture. Uterine rupture was surgically repaired with a double-layer suture with fetal preservation. Following uterine repair, the pregnancy was successfully prolonged by more than 10 weeks and the patient delivered a healthy newborn at 33 weeks and 6 days. Conclusions: Early diagnosis and appropriate surgical intervention allowed the continuation of pregnancy and delivery at 33 weeks and 6 days resulting in favorable neonatal outcomes in this high-risk case. Uterine rupture in the mid-trimester increases the complexity of management, as traditional intervention strategies may need to be adapted to ensure both maternal and fetal safety. This case supports conservative surgical repair as a potential management option in carefully selected cases of mid-trimester uterine rupture.