Spontaneous Uterine Rupture at 26 Weeks of Gestation after Uterine Artery Embolisation for Adenomyosis

Spontaneous uterine rupture is a rare but catastrophic obstetrical emergency associated with high perinatal and maternal mortality.Uterine artery embolisation (UAE) as a risk factor for uterine rupture is less well-described in the literature; its effect on pregnancy seems to be underestimated.Here we report a case of spontaneous uterine rupture at 26 weeks of gestation presenting with abdominal pain and hypovolaemic shock.The patient had undergone UAE for the management of adenomyosis six years ago.Urgent laparotomy revealed a ruptured uterus with a large haemoperitoneum.Clinicians should pay more attention to women after non-invasive surgery such as UAE.MRI to evaluate the myometrial condition is recommended even for primigravida without any previous history of uterine surgery.