• Yue Chen, Ying Cao, Jing-Yao She, Si Chen, Pei-Juan Wang, Zheng Zeng, and Chun-Yun Liang.
• The Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China.
• Medicine (Baltimore). 2023 Jun 16; 102 (24): e33977e33977.

RationaleIn most cases, uterine rupture occurs during the third trimester of pregnancy or during labor. Even fewer reports have been published about the occurrence of this condition without a gynecologic history of any surgical procedure. Due to their scarcity and variable clinical presentation, early diagnosis of uterine rupture may be difficult, and if the diagnosis is not timely, the condition may be life-threatening.Patient ConcernsHerein, 3 cases of uterine rupture from a single institution are described. Three patients are at different gestational weeks and all have no history of uterine surgery. They came to the hospital due to acute abdominal pain, which is characterized by severe and persistent pain in the abdomen, with no apparent vaginal bleeding.DiagnosesAll 3 patients were diagnosed with uterine rupture during the operation.InterventionsOne patient underwent uterine repair surgery; while the other 2 underwent subtotal hysterectomy due to persistent bleeding and pathological examination after surgery confirmed placenta implantation.OutcomesThe patients recovered well after the operation, and no discomfort occurred in the follow-up.LessonsAcute abdominal pain during pregnancy can pose both diagnostic and therapeutic challenges. It is important to consider the possibility of uterine rupture, even in cases where there is no history of prior uterine surgery. The key to the treatment of uterine rupture is to shorten the diagnosis time as much as possible, this potential complication should be carefully monitored for and promptly addressed to ensure the best possible outcomes for both the mother and the developing fetus.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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