Background: Uterine rupture was a common occurrence at previously cesarean-sectioned scar. Early sign of uterine rupture was a severe fetal bradycardia.
Case Report: A 30-year-old, 3 gravida, 1 para woman was presented with an acute abdominal pain and hypovolemic shock. Her gestational age was estimated at 18 weeks by emergency pelvic ultrasound. She had a lower segment scar from a previous caesarean section. Initially, alive intrauterine pregnancy with massive hemoperitoneum was a provisional diagnosis. During exploratory laparotomy, a ruptured of the right uterine fundus was found with placenta percreta. Hysterectomy was performed. Fetal weight was 450 grams, APGAR score 0, 0 and the fetus could not survive. The patient was discharged on the 4th day after surgery in healthy condition.
Conclusion: Uterine rupture is a catastrophic situation. Severe fetal bradycardia might be an early sign. This case demonstrates the importance of clinical judgment based on clinical acumen.

Keywords: Uterine rupture, Placenta percreata, Non-scar site