Extrauterine amniotic sac (amniocele). Clinical workup in a case of silent uterine rupture.

Uterine rupture in pregnancy is recognized as being the most prevalent among the major misfortunes that can be encountered in obstetric practice. The rate varies from 1 in 100 to 1 in 11,000 deliveries. 1 This severe complication is a principal cause of maternal death and was reported to be the ninth most common cause of maternal death in England and Wales from 1975 to 1977 (4.7% of all maternal deaths)z and up to 5% of pregnancy-related maternal deaths in the United States. 1 The chances for fetal survival are dismal: Fetal mortality rates in various studies ranged between 50% and 75%.3 This is a case of symptomless uterine rupture in which alterations of fetal heart rate at routine non-stress test (NST) necessitated a further ultrasonographic examination. Extrusion of an amniotic sac containing fetal parts into the abdominal cavity was demonstrated.