{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T07:17:38Z","timestamp":1768547858221,"version":"3.49.0"},"reference-count":10,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,11,21]]},"abstract":"<jats:p>Rupture of the vaginal wall in unobstructed labour is a rare entity in the developed world. This case report describes rupture of the posterior cul-de-sac in a healthy 34-year-old multiparous woman attempting trial of labour after caesarean section. The woman presented to the labour ward at term with spontaneous onset of contractions. In the second stage of labour, the woman experienced sudden severe abdominal pain, different in character from the contraction pain. Therefore, the baby was delivered by ventouse extraction. As the woman continued to experience severe immobilising abdominal pain during the hospital stay, a CT scan was performed which revealed a haematoma and free fluid at the right side of the uterus. A laparotomy was performed 3\u2009days postdelivery, during which a rupture of the posterior cul-de-sac was found and closed with a continuous suture. The woman was discharged 3\u2009days after laparotomy in good clinical condition.<\/jats:p>","DOI":"10.1136\/bcr-2017-221149","type":"journal-article","created":{"date-parts":[[2017,12,2]],"date-time":"2017-12-02T12:00:28Z","timestamp":1512216028000},"page":"bcr-2017-221149","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Rupture of the posterior cul-de-sac during trial of labour after caesarean section"],"prefix":"10.1136","volume":"2017","author":[{"given":"Lysanne D C","family":"Graafmans","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marja G K","family":"Dijksterhuis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louwerens D","family":"Vos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeroen","family":"van Bavel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,12,2]]},"reference":[{"key":"2025042713115737000_2017.dec02_1.bcr-2017-221149.1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000239439.04364.9a"},{"key":"2025042713115737000_2017.dec02_1.bcr-2017-221149.2","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1080\/jmf.16.5.295.296","article-title":"The rupture through posterior vaginal fornix of the posterior lower uterine segment","volume":"16","author":"Cetinkaya","year":"2004","journal-title":"J Matern Fetal Neonatal Med"},{"key":"2025042713115737000_2017.dec02_1.bcr-2017-221149.3","first-page":"442","article-title":"Complete and spontaneous rupture of douglas\u2019 pouch during normal labor","volume":"21","author":"Bertaud","year":"1969","journal-title":"Bull Fed Soc Gynecol Obstet Lang Fr"},{"key":"2025042713115737000_2017.dec02_1.bcr-2017-221149.4","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1097\/AOG.0b013e3181bd8a61","article-title":"Rupture of the posterior cul-de-sac during spontaneous labor","volume":"115","author":"Young","year":"2010","journal-title":"Obstet Gynecol"},{"key":"2025042713115737000_2017.dec02_1.bcr-2017-221149.5","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1080\/01443610601062952","article-title":"An unusual case of tear in the pouch of douglas following spontaneous vaginal delivery in a previously scarred uterus","volume":"27","author":"Shantha","year":"2007","journal-title":"J Obstet Gynaecol"},{"key":"2025042713115737000_2017.dec02_1.bcr-2017-221149.6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2012\/786753","article-title":"Spontaneous rupture of the anterior vaginal wall during the first stage of labour","volume":"2012","author":"Schultz","year":"2012","journal-title":"Case Rep Obstet Gynecol"},{"key":"2025042713115737000_2017.dec02_1.bcr-2017-221149.7","first-page":"512","article-title":"Delivery through the maternal bladder during trial of labor","volume":"80","author":"Spaulding","year":"1992","journal-title":"Obstet Gynecol"},{"key":"2025042713115737000_2017.dec02_1.bcr-2017-221149.8","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/15.5.1198"},{"key":"2025042713115737000_2017.dec02_1.bcr-2017-221149.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2010.11.009"},{"key":"2025042713115737000_2017.dec02_1.bcr-2017-221149.10","doi-asserted-by":"publisher","DOI":"10.2353\/ajpath.2010.091209"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-221149","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T20:12:02Z","timestamp":1745784722000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-221149"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,2]]},"references-count":10,"alternative-id":["10.1136\/bcr-2017-221149"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-221149","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,2]]}}}