Spontaneous rupture of a uterine artery in pregnancy, a rare OB/GYN emergency with high mortality, should be suspected in patients with unexplained large volume free intraperitoneal fluid and active contrast extravasation adjacent to adnexal structures. Patients should be emergently referred to obstetrics and gynecology, surgery, and interventional radiology for vessel ligation to protect both mother and fetal hemodynamic stability. Patient prognosis remains fair to good depending on rapid recognition of diagnosis and hemodynamic stability.

From the manuscript

Spontaneous Rupture of the Uterine Artery in an Otherwise Normal Pregnancy

Abstract
Spontaneous rupture of a uterine artery in pregnancy is associated with a high rate of mortality. Although uterine artery rupture has been associated with postpartum hemorrhage, it is rarely found during pregnancy. Unfortunately, clinical signs and symptoms are usually vague and nonspecific. We report a case of a 36-year-old woman at 20 weeks gestation presenting with abdominal pain who was found to have a spontaneous uterine artery rupture. To our knowledge, this is the first case report demonstrating imaging findings in a patient with this condition. Our patient underwent successful ligation of the uterine vessel with preservation of both mother and fetus. We will discuss possible etiologies of uterine artery rupture during pregnancy, associated imaging findings, and management options.