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Successful treatment of a heterotopic cervical pregnancy and twin gestation by sonographically guided instillation of hyperosmolar glucose

syndrome, (ruptured) ectopic pregnancy, ovarian torsion, chorioamnionitis, and uterine rupture. Uterine rupture and (non-traumatic) spleen rupture are the two most common causes of intraperitoneal bleeding during pregnancy (1). Intraperitoneal bleedings without a cause, a so called apoplexy, outside a pregnacy is rarely seen (2). Spontaneous rupture of an unscarred uterus during pregnancy is very rare. Rupture during labor is well known, especially in cases of uterine wall weaknesses. Uterine wall weakness can be because of trauma surgical or non-surgical prolonged labor, placenta percreta, augmentation of labor, instrumental deliveries, or fundal pressure. One could postulate that the horse fall might have caused damage to the uterine wall. Probably, a laceration developed over time in the fundus because of uterine contractions. Conclusion