(Disclaimer: This article is for scientific purposes only, in order to protect the patient’s privacy, the relevant information in the following content has been processed) Abstract: Maternity previous cesarean section, unplanned second pregnancy, the process of labor and delivery examination went smoothly, after the initiation of contractions, asked for a vaginal trial of labor, the doctor was given to closely observe the progress of the process of labor, and in the uterus after the mouth is opened to instruct the mother to push, the sudden rupture of the original scar, resulting in pathologic contraction of the ring, fetal distress, hematuria. Immediate cesarean section helped the fetus to be delivered smoothly, and uterine repair was performed. After the operation, the uterus was well restored, the abdominal wound healed well, and there was little vaginal bleeding. Basic information] Female, 34 years old [Type of disease] Uterine rupture [Hospital] Jiangbin Hospital, Guangxi Zhuang Autonomous Region [Date of consultation] July 2021 [Treatment plan] Surgical treatment (cesarean section + uterine repair) + medication (contraction injection + carbapenem aminobutanetriol injection + ceftriaxone sodium for injection + hematopoietin) + neonatal resuscitation 【Treatment period] Hospitalization 7 days 【Treatment effect】 Fetus delivered smoothly, uterus well restored, abdominal wound healed well, not much vaginal bleeding I. Initial interview 34-year-old woman had 1 abortion in the past, and 1 cesarean section in 2013 due to fetal distress, and the process went smoothly. Her last menstrual period was on October 15, 2020, and this was an unplanned pregnancy. She went to the hospital more than 1 month after menopause, and ultrasound showed that she had an early intrauterine pregnancy, and her expected date of delivery was July 22, 2021, so she and her family decided to continue with the pregnancy after discussion. The mother and her family decided to continue the pregnancy. 12 weeks of pregnancy card and regular obstetrical examination, 20 weeks of pregnancy began to self-conscious fetal movement, the process of obstetrical examination went smoothly, non-invasive DNA, systematic ultrasound did not see any obvious abnormalities, late pregnancy self-counting fetal movement is normal. 18 o’clock on July 12, there was a small amount of vaginal bleeding, accompanied by irregular lower abdominal distension and pain, and then went to the obstetrics department to consult the fetal monitoring suggests that the contractions are not irregular, the fetal heartbeat is normal, diagnosis of pregnancy 3 birth 1, 38 + weeks of gestation, the live fetus with a preeclampsia, scarred uterus, was admitted to the hospital. She was admitted to the hospital. After admission to the hospital, relevant examinations were completed, and fetal ultrasound indicated that the fetus was in cephalic position, with an estimated weight of about 3100 g. The doctor assessed that there was no obvious abnormality in the mother’s birth canal, and told the mother and her family that the last cesarean section was due to fetal distress, and that no fetal distress had occurred in the current pregnancy, that the mother’s birth canal was normal, and that the position of the fetus was normal, and the baby was not too big, so it was possible to choose either a trial of labor or a cesarean section, which was discussed by the mother and her family. After discussion with her family, she requested a vaginal trial of labor. At 6:30 on July 13, regular contractions appeared, and the mother was given close observation of the progress of labor, which progressed smoothly. At 19:15, the uterine opening was opened completely, the head of the fetus was -2, the contractions were good, and the fetal heart rate was normal, so the mother was sent to the delivery room, given cardiac and electric monitoring, intravenous fluids were turned on, a urinary catheter was left in place, and the mother was instructed to push, and 20 minutes later the mother complained of pain in the lower abdomen, a pathologic contraction ring appeared in her abdomen, and her heart rate was obviously increased, and bloody urine appeared in the urinary catheter. Hematuria appeared in the urinary catheter. Considering uterine rupture, emergency cesarean section was immediately performed in the delivery room, and the fetus was taken out 5 minutes later, and neonatal asphyxia resuscitation was immediately performed. During the operation, a rupture of about 5cm was seen at the original cesarean section scar, and the rupture was partially prolonged towards the cervix, and uterine repair was performed after cesarean section. The surgical process was smooth, the newborn was successfully resuscitated and was transferred to neonatology department for further treatment. the uterine fissure was repaired during the operation, and the uterine contraction therapy was given with hysteronin injection and carboprost tromethamine injection to reduce the uterine bleeding, and the intraoperative bleeding was about 750 ml. the postoperative blood test was repeated, and the leukocytes were 14.45×10^9/L, hemoglobin was 92 g/L, and the injectable ceftriaxone sodium was given to treat the uterine bleeding. Ceftriaxone sodium anti-inflammatory treatment, and oral blood replenishment treatment was given with Shengshuibao Combination. On the 7th day of hospitalization, the maternal vital signs were normal, and the routine blood test was repeated, the cells were 8.62×10^9/L, hemoglobin: 95g/L, the uterus was well restored, the abdominal wound was well healed, and there was not much vaginal bleeding, so she was discharged from the hospital. IV. Precautions It was gratifying that after timely surgical treatment, the fetus was successfully delivered and the mother recovered well. When uterine rupture occurs and uterine repair is performed, the chances of uterine rupture occurring in another pregnancy are very high, so it is recommended that the mother try to do a good job of avoiding it and avoiding another pregnancy. Multiple cesarean sections make the abdominal wounds more difficult to heal than the first operation, so mothers are advised to pay attention to the healing of the wounds, and return to the hospital in time for treatment if there is any fever, pain, or oozing of fluid from the wounds. Pelvic floor function assessment and rehabilitation should be performed after delivery to help repair the uterus for better recovery and reduce pelvic organ prolapse. Uterine rupture is easy to cause psychological shock and fear to the mother, it is recommended that family members give more love and care, to help share the hard work of bringing up children, let the mother rest more, to ensure a happy mood, which is more conducive to post-partum recovery. V. Individual perception For the second delivery after cesarean section, generally more women choose to have another cesarean section, which is relatively safe. However, if there is no factor for the last cesarean section, and the condition of the birth canal and the condition of the fetus are normal, if the mother wants to have a trial of labor vaginally, and the hospitals have the conditions for emergency rescue in the delivery room, the mother can be given a trial of labor under close observation. Women with scarred uterus are at risk of uterine rupture at any time during the trial of labor, especially in the second stage of labor, so they should be prepared to be resuscitated at any time in order to save the lives of both mother and child in a timely manner.