BACKGROUND: Unscarred uterine rupture in association with systemic lupus erythematosus (SLE) and long-term steroid treatment is rare.
CASE: A 36-year-old primigravid woman conceived a twin gestation after in vitro fertilization therapy. At 23 weeks of gestation, she was found to have a spontaneous rupture of the uterus. Her medical history was significant for SLE for a duration of 19 years, and her condition had been maintained with prednisolone. She had no history of uterine scarring or other known risk factors for uterine rupture. The uterine fundus was the main location of the rupture and a subtotal hysterectomy was performed.
CONCLUSION: Long-term treatment with systemic steroids and SLE may increase the risk of spontaneous rupture of an unscarred uterus.