Background and Aim: Occurrence of pregnancy in a perforated uterus is a rare phenomenon and can have serious consequences. The absence of peritoneal symptoms may be due to healthy amniotic membranes and lack of extrusion of intra-abdominal pregnancy products. Bleeding may be vaginal or inside the abdominal pelvic cavity. We report a case of pregnancy in a perforated uterus in a woman with a history of curettage in the last year.
Case presentation: A 38-year-old woman, gravid 1, with a gestational age of 36 weeks and 4 days, was admitted to "Besat Hospital" in Sanandaj with complaints of labor pain and reduced fetal movement. The patient had a history of endometrial polyp removal through curettage surgery in the last year and underwent emergency cesarean section due to recurrent variations in the fetal heart rate and fetal distress. During the cesarean section, we noticed a hole measuring 3×3 cm and an apparently healthy live baby boy. The baby was born with an Apgar score of  9/10. The hole in the fundus of the uterus was repaired.
Conclusion: Pregnancy with a perforated uterus and the birth of a healthy baby in such a condition are rare phenomena. In order to reduce the incidence rates of maternal mortality and loss of pregnancy products in gynecological surgeries, such as curettage, at reproductive age more care is required.