Uterine rupture is an obstetric mishap with associated morbidity and mortality consequences for the fetus and the mother. Promptness and accuracy of diagnosis of uterine rupture will help in instituting interventions to reduce these complications. Sometimes, the clinical presentations such as abdominal pain, abnormal fetal heart rate or intrauterine fetal death, bleeding per vaginam and loss of previously noted fetal station in a parturient may not be typical in uterine rupture. Previous uterine surgeries such as caesarean section, dilatation and curettage, myomecctomy or use of uterotonic agents for induction or augmentation of labour are the prominent risk factors. This case is unique because she has no such risk factors. However, there was sudden onset of generalized abdominal pain, readily palpable fetal parts, no fetal heart tone with ultrasound confirmation of intrauterine fetal death and the maternal hemodynamic status deteriorated rapidly raising the suspicion of a very rare occurrence of spontaneous uterine rupture with no obvious prior uterine scar. This atypical presentation delayed the diagnosis which might have accounted for the fetal loss, but emergency exploratory laparotomy saved the women with a maternal near-miss experience.
