Umbilical Cord Prolapse through Urethra Due to Complicated Uterine Rupture

Uterine rupture is a rare but potentially fatal complication of pregnancy with life-threatening maternal and fetal consequences. We present a case of umbilical cord prolapsed through urethra due to complicated uterine rupture in a patient with severe pre- eclampsia. A multiparous woman in her 30s, with history of untreated preeclampsia during this pregnancy and two previous Cesarean sections presented with spontaneous leakage of amniotic fluid in a full-term unmonitored pregnancy and occipital headache. The general physical examination showed high blood pressure values, and fetal demise was diagnosed using abdominal ultrasound. During the preparation for Cesarean section the patient developed complicated uterine rupture with urinary bladder lesion resulting in umbilical cord prolapse through the urethra. An emergency laparotomy and supravaginal hysterectomy were performed due to impossibility to repair the uterine wall. The fact that uterine rupture is a life-threatening obstetric emergency and that it is associated with high maternal and perinatal mortality indicates the necessity to consider the risk of rupture and to follow-up on the patient to prevent complications.