A 33-year-old French woman, who presented for a routine ultrasound at 22 weeks pregnant, had no idea that her uterus had ruptured and that part of her amniotic sac was spilling out. And, while mum and dad welcomed a healthy baby boy eight weeks later, it was certainly no ordinary pregnancy.
The incredible MRI image of the woman's sixth pregnancy - her fetus's legs and feet visible in the amniotic sac - was published in a report in The New England Journal of Medicine this week.
A closer look: The rupture (indicated by the white arrows) and the protruding amniotic sac, which contains the baby's legs. Image: The New England Journal of Medicine
Lead author Dr Pierre-Emmanuel Bouet, an OB/GYN at Angers University Hospital, France, told Live Science that it was the first time he had seen the "extremely rare" condition. In fact there have only been 26 cases recorded in the medical literature.
According to the report, the mother sustained a 2.5cm tear in her uterine wall. Through the rupture, part of the amniotic sac (measuring 9cm by 12 by 9cm) then popped out.
For any nervous pregnant mums currently clutching the budding soccer player/ballerinas in their bellies, don't worry - baby didn't kick his way through her uterus.
The woman, who did not experience any symptoms prior to her scan, had delivered all five of her previous babies via Caesarean section. According to Dr Bouet, it was the C-sections that ultimately increased her risk for a uterine tear. The deliveries, he explained, weakened the wall of her uterus. And, while the tear didn't occur at the exact location of her previous C-sections, Dr Bouet described the rupture as being "close by".
"The area of the uterus that had scarred after the C-sections was strong, but the regions around this scar were fragile," Dr Bouet told Live Science, adding that the forces and pressures on the uterus, which occur during pregnancy, then resulted in the tear.
Having discovered the rupture, Dr Bouet explained that the mum - and her partner - were faced with several potential risks: additional tearing of the uterus, pre-term birth, hysterectomy and placenta accreta (where the placenta doesn't detach from the uterine wall after birth). It was also possible, Dr Bouet noted, for the amniotic sac to rupture. The couple chose to proceed with the pregnancy under close monitoring.
Eight weeks later, at 30 weeks pregnant, the uterine tear had grown by 5cm. The part of the amniotic sac, which was outside the uterus, had also grown larger. And by now, the report notes, it also included, "the fetal abdomen and legs".
At this stage, doctors chose to deliver the baby via C-section, the pair welcoming a healthy baby boy weighing in at 1.385kg.
And in a wonderful update, six months later mum and bub are healthy and well, according to the case report.
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