A rare cause of severe oligohydramnios in the third trimester secondary to uterine perforation due to unsafe abortion: A case report

Abstract

Background: Uterine perforation following an unsafe abortion is rare but can lead to severe maternal morbidity and mortality.

Case presentation: A 28-year-old para 0+1 at 34 weeks gestation, presented with a history of generalized abdominal pain and reduced fetal movements for one week. Ultrasound revealed severe oligohydramnios; however, she did not have a history of liqor drainage. She was scheduled for emergency cesarean delivery. Intraoperatively, approximately 300mls of free clear fluid was noted. A live female infant weighing 2200 grams and with Apgar scores of 9, 10, and 10 at 1, 5, and 10 minutes was extracted. Perforation at the fundus of the uterus, which was probably due to unsafe abortion, was noted. The edges of the uterine perforation were refreshed and closed in two layers. Her postoperative period was uneventful, and the mother and the neonate were discharged home.

Conclusion: A high suspicion index should be indicated in patients presenting with isolated oligohydramnios with a previous history of unsafe abortion and uterine perforation, particularly in regions where unsafe abortion is common.