9.17 Uterine Rupture

Question 1

What is the difference between an incomplete and a complete uterine rupture?

Answer 1

In a complete rupture the serosa is also broken and contents released into abdominal cavity.

(Incomplete the serosa is intact aka uterine dehiscence)

Question 2

What are some risk factors for uterine rupture?

Answer 2

previous Caesarean section is main risk.

• Vaginal birth after caesarean (VBAC)
• Previous uterine surgery
• Increased BMI
• High parity
• Increased age
• Induction of labour
• Use of oxytocin to stimulate contractions

Question 3

How does uterine rupture present?

Answer 3

Unwell mother, abnormal CTG often following induction or augmentation of labour.

• Abdominal pain
• Vaginal bleeding
• Ceasing of uterine contractions
• Hypotension
• Tachycardia
• Collapse

Question 4

Management of uterine rupture?

Answer 4

• resus and transfusion
• emergency c-section to remove the baby
• repair uterus / hysterectomy