Posterior Cul-de-sac rupture is a rare delivery complication and a diagnostic challenge to every obstetrician. The associated predisposing factors include genital anomalies (such as vaginal atresia), the use of misoprostol to induce delivery, previous pelvic infection, and caesarean scar. Herein, we report the case of a posterior Cul-de-sac rupture without any disposing risk factor.
A 27-year-old G5P4 pregnant woman at the 33rd week of gestation presented with spontaneous onset of labor, the administration of calcium channel blockers failed to stop her active labor, which progressed with a spontaneous rupture of membranes. The fetal heart rate decelerated suddenly to 40 beats per minute. Therefore, an emergency lower transverse cesarean section was performed. During the operation, a transverse 6 cm tear in the posterior vaginal wall was found. The ruptured vagina was sutured and the patient was discharged two days later in a good condition.
Posterior Cul-de-sac rupture is a rare –but serious-delivery complication.
Posterior Cul-de-sac rupture could happen spontaneously without any predisposing risk factor.
In most cases, the rupture manifests as sudden abdominal pain.
The early detection and management of such cases can reduce morbidity and mortality.