Spontaneous Uterine Rupture in a Multigravid Pregnant Woman with Unscarred Uterus on Chronic Steroid Use: A Case Report

J Obstet Gynaecol Can. 2021 Jan;43(1):82-84. doi: 10.1016/j.jogc.2020.04.005. Epub 2020 Apr 26.

Abstract

Background: Uterine rupture in pregnancy is associated with severe maternal and fetal complications. Although it is a rare event, uterine rupture has been associated with certain risk factors. Glucocorticoids are known to weaken skeletal muscles; however, there have been no studies on the effects of chronic steroid use on the uterine myometrium.

Case: We present the case of a 40-year-old multigravid woman who experienced a posterior uterine wall rupture on an unscarred uterus. She was on chronic glucocorticoids for the treatment of psoriatic arthritis. We hypothesize that the catabolic effects of glucocorticoids on skeletal muscles also weakened the uterine myometrium, leading to a higher risk of uterine rupture.

Conclusion: Uterine rupture may be associated with chronic use of corticosteroids. Identifying the different risk factors for uterine rupture can lead to more prompt diagnosis and management of uterine rupture, resulting in better maternal and fetal outcomes.

Keywords: corticosteroids; pregnancy complications; risk factors; uterine rupture.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Arthritis, Psoriatic / drug therapy*
  • Female
  • Glucocorticoids / adverse effects*
  • Glucocorticoids / therapeutic use
  • Humans
  • Pregnancy
  • Pregnant Women
  • Rupture, Spontaneous / chemically induced*
  • Steroids
  • Uterine Rupture / chemically induced*
  • Uterus

Substances

  • Glucocorticoids
  • Steroids