Obstetrics & Gynecology

Skip Navigation LinksHome > February 2010 - Volume 115 - Issue 2, Part 2 > Rupture of the Posterior Cul-De-Sac During Spontaneous Labor

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Obstetrics & Gynecology:
doi: 10.1097/AOG.0b013e3181bd8a61
Case Reports

Rupture of the Posterior Cul-De-Sac During Spontaneous Labor

Young, Brett MD; Takoudes, Tamara MD; Lim, Kee-Hak MD; Rana, Sarosh MD

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Abstract

BACKGROUND: Women with genital anomalies are at increased risk of labor dysfunction. Rupture of the posterior cul-de-sac causing an intraabdominal delivery is a rare complication of labor that may be related to a congenitally atretic vagina.

CASE: A nulliparous woman at 28 weeks of gestation with a known short vagina presented with preterm labor; her cervix could not be palpated or visualized. At cesarean delivery, the cervix was intraabdominal and the fetal head was delivered in the abdomen. A large rent in the posterior cul-de-sac required repair to restore correct anatomical positioning. The uterus was intact.

CONCLUSION: Rupture of the posterior cul-de-sac is a rare event that can cause significant maternal and fetal morbidity.

© 2010 The American College of Obstetricians and Gynecologists

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