| Summary: | Rupture of uterine is an important side effect of pregnancy for health policy in developing countries. It is a rare event that causes maternal mortality and fetal morbidity. A 27-year old woman in the gestational age of 23 weeks who was admitted to the hospital because of a vague abdominal pain for 5 days. Her previous ultrasound which was done two weeks later reported as an intrauterine fetus with normal umbilical cord and normal volume amniotic fluid. There was no sign of ectopic pregnancy. The patient recommended being evaluated by abdominal and pelvic magnetic resonance imaging with/without gadolinium. Magnetic resonance imaging (MRI) results showed normal position of the uterus opening in the cesarean scar. In subhepatic tissue, single fetus in transverse position on the anterior bowel loops was evident. On the serosal surface of the uterine fundus, a mixed signal with a size of 125×95 millimeters in favor of placenta was seen. After resuscitation with intravenous fluids, the patient was prepared for surgery. Emergency laparotomy was done. The patients with abdominal pain and vaginal bleeding during pregnancy who have this risk factor should be mentioned for uterine rupture as a critical differential diagnosis if the diagnosis is confirmed they should be a candidate for emergency laparotomy and massive transfusion and fluid resuscitation.
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