1 Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
2 Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
3 Maternal Fetal Medicine Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga / Airlangga Universitas Academic Hospital, Surabaya, Indonesia
* Corresponding Author: Ina Soraya. Email: dr.nahlfirdausi@gmail.com
Uterine rupture in an unscarred uterus is an exceptionally rare and potentially catastrophic obstetric event, typically presenting with dramatic maternal and fetal compromise. We report an unusual case of a clinically silent incomplete uterine rupture in a 28-year-old gravida 3 para 1 woman at term, residing in a modern metropolitan city with an established obstetric referral system. The patient had no history of uterine surgery, induction of labor, or trauma, and presented without classical symptoms of uterine rupture. On admission, maternal vital signs were stable and fetal heart rate monitoring was reassuring. The rupture was discovered incidentally during cesarean delivery planned for prolonged rupture of membranes, fetal growth restriction and fetal distress. Intraoperative findings revealed a contained serosal–myometrial tear in the lower uterine segment, with localized bleeding and no breach of the uterine cavity, consistent with an incomplete uterine rupture. Notably, the only identifiable potential risk factor was a history of repeated traditional abdominal massage during the third trimester, performed with the intention of improving fetal position. An emergency cesarean section resulted in the delivery of a live neonate with good Apgar scores, and the mother had an uneventful postoperative recovery. This case highlights the diagnostic challenge of silent uterine rupture in unscarred uteri, underscores the importance of maintaining clinical vigilance even in low-risk pregnancies, and illustrates how potentially harmful traditional practices may persist in urban settings with advanced healthcare access. Greater emphasis on culturally sensitive maternal health education is essential to prevent rare but serious obstetric complications.
Keywords: Uterine rupture, unscarred uterus, traditional abdominal massage, metropolitan obstetrics, term pregnancy, silent rupture, maternal and fetal outcome
How to cite this article: Soraya I, Hermanto TJ. Silent incomplete Uterine Rupture in an Unscarred Uterus at Term: A Rare Case Possibly Associated with Traditional Abdominal Massage in a Modern Metropolitan Setting. Int J Drug Deliv Technol. 2026;16(5): 254-257. DOI: 10.25258/ijddt.16.5.28
Source of support: Nil.
Conflict of interest: None