Spontaneous posterior uterine rupture following vaginal delivery in an unscarred uterus

Primary uterine rupture, defined as rupture of an unscarred uterus during pregnancy or delivery, is a rare but catastrophic obstetric emergency. The estimated incidence is approximately 1 in 16 840-19 765 deliveries in developed nations. We report a case of a multiparous woman in her early 30s who presented in spontaneous labour and developed haemorrhagic shock following an apparently uncomplicated vaginal delivery. Rapid recognition of concealed bleeding led to emergent laparotomy, revealing a left posterior uterine wall rupture involving the venous plexus. Surgical control with supracervical hysterectomy and multidisciplinary management-including interventional radiology review at a tertiary centre-achieved complete haemostasis and recovery. This case underscores the importance of early recognition and rapid escalation when postpartum bleeding persists despite standard therapy.