Precipitate birth definition12/10/2023 ![]() ![]() Her vitals were stable and uterus was contracted, but still she was having profuse vaginal bleeding. As per Advanced Life Support in Obstetrics (ALSO) guidelines, a second large bore intravenous line, continuous monitoring of vital signs, bimanual uterine massage, oxytocin infusion, intramuscular methylergonivine, misoprostol 1 mgm per rectal, blood group typing and cross match etc. Immediately after delivery of the baby and complete placenta, there was excessive vaginal bleeding. The labor was not induced or augmented, however the patient mentioned eating date fruits. She progressed spontaneously from 3 cm to full dilatation in one hour and within 15 minutes she had a spontaneous vaginal delivery with right medio-lateral episiotomy of a singleton live healthy female baby of 3.2 kg with Apgar 9 at 1 minute. She was admitted to the hospital at 39 weeks of gestation in latent phase of labor with a singleton fetus in left occipito-anterior (LOA) position. Patient had an uneventful antenatal course and had made an informed decision for a planned vaginal birth after cesarean section (VBAC). The patient was 32 year old, gravida 2, para 1 women who had a past history of cesarean delivery by low transverse incision, having delivered a 3.8 kg healthy male child. We hereby present one such extremely rare case of primary, spontaneous, complete colporrhexis during precipitate vaginal birth after caesarean section. While secondary colporrhexis is reported along with vaginal birth after caesarean section, a reported case of primary colporrhexis after previous caesarean section is apparently rare. The etiology of the infrequent primary spontaneous colporrhexis as in our case is mostly hypothetical. Majority of cases of primary colporrhexis are of traumatic origin. It can be life-threatening and easily missed, with the diagnosis being overlooked. ![]() Colporrhexis causing separation of cervix from the vaginal fornix is an unanticipated, but perilous complication of labor.
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