Uterine Rupture at 21 Weeks in Twin Pregnancy with TTTS and
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Uterine rupture is defined as the complete disruption of all uterine layers, including the serosa. Undiagnosed and untreated, this is a life-threatening complication for mother and fetus. Other adverse outcomes related to uterine rupture are bladder laceration, severe hemorrhage, hysterectomy, and neonatal morbidity related to intrauterine hypoxia.

A large majority of uterine rupture occurs in the setting of a vaginal birth after caesarean (VBAC), resulting in intrapartum injury and spontaneous rupture of a gravid uterus. Out of hospital trauma represents the remainder of etiologies for uterine rupture. Motor vehicle accidents, domestic violence, and falls are the most common causes of blunt trauma during pregnancy. This article reports a case of uterine rupture at 21 weeks of gestation in a patient with a previous C-section and currently pregnant with a monochorionic twin pregnancy complicated by twin to twin transfusion syndrome (TTTS) and premature contractions.

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