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Y4R2 - Obstetrics I 🤰 > L11: Maternal Obstetric Injuries (Rupture Uterus) > Flashcards

L11: Maternal Obstetric Injuries (Rupture Uterus) Flashcards

1
Q

Def of Rupture Uterus

A

Loss of continuity of uterine wall not done by surgery.

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2
Q

Incidence of Rupture Uterus

A
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3
Q

Incidence of Rupture Uterus

  • More common in?
A
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4
Q

Etiology of Rupture Uterus

A
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5
Q

Etiology of Rupture Uterus

  • Main Cause
A

previous CS scar

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6
Q

Etiology of Rupture Uterus

  • During Pregancy (Spontaneous)
A
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7
Q

Etiology of Rupture Uterus

  • During Pregnancy (Traumatic)
A

Traumatic: Rare.
1) ECV.
2) External trauma to abdomen: falls, kicks, car accidents or stab wounds.

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8
Q

Etiology of Rupture Uterus

  • During labor (Spontaneous)
A

Spontaneous: More common.

1) Obstructed labor.

2) Rupture of uterine scar.

3) Grand multiparity: d2 degeneration & weakness of uterine muscles.

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9
Q

Etiology of Rupture Uterus

  • During Labor (Traumatic)
A
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10
Q

Etiology of Rupture Uterus

  • During Labor (Improper use of oxytocin or PGs)
A

….

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11
Q

Types of Rupture Uterus

A
  1. Incomplete: 20% Rupture doesn’t involve peritoneum
  2. Complete: 80% Rupture involves all layers of uterus even peritoneum
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12
Q

Sites of Rupture Uterus

A
  • UUS rupture: Mostly complete & occurs during pregnancy or early in labor
  • LUS rupture: May be incomplete or complete & usually occurs during labor
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13
Q

Type of Rupture in Rupture of uterine scar

A
  • incomplete (dehiscence) or complete
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14
Q

Rupture of uterine scar

  • Site
A
  • At site of the scar
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15
Q

Rupture of uterine scar

  • Shape
A
  • Shape of the scar
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16
Q

Rupture of uterine scar

  • Predisposing factors
A
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17
Q

Rupture uterus due to obstructed labor

  • Type
A

Complete

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18
Q

Rupture uterus due to obstructed labor

  • Site
A

Involves LUS but may extend upwards into UUS or downwards into cervix.

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19
Q

Rupture uterus due to obstructed labor

  • Mechanism
A

See obstructed labor

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20
Q

Rupture uterus due to obstructed labor

  • Shape
A

Oblique

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21
Q

Complications of Rupture Uterus

A
22
Q

Complications of Rupture Uterus

  • Maternal
A
23
Q

Complications of Rupture Uterus

  • fetal
A
24
Q

CP of Rupture Uterus

A
25
Q

CP of Rupture Uterus

  • Spontaneous rupture during pregnancy
A
26
Q

CP of Rupture Uterus

  • Spontaneous rupture during pregnancy (Impending rupture)
A

a. Lower abdominal pain
b. tenderness over scar
c. vaginal spotting.

27
Q

CP of Rupture Uterus

  • Spontaneous rupture during pregnancy (Actual Rupture)
A
28
Q

Symptoms of Spontaneous actual rupture uterus during pregnancy

A
29
Q

Signs of Spontaneous actual rupture uterus during pregnancy

A
30
Q

Signs of Spontaneous actual rupture uterus during pregnancy

  • General
A

Signs of hypovolemic shock.

31
Q

Signs of Spontaneous actual rupture uterus during pregnancy

  • Abdominal
A
32
Q

Signs of Spontaneous actual rupture uterus during pregnancy

  • Vaginal
A

a- Vaginal bleeding may be present.
b- Presenting part is high.

33
Q

CP of Spontaneous rupture during labor

A
34
Q

CP of Spontaneous rupture during labor

  • Impending Rupture
A

C/P of obstructed labor.

35
Q

CP of Spontaneous rupture during labor

  • Actual Rupture
A
36
Q

CP of Spontaneous Actual rupture during labor

  • Symptoms
A
  • Sudden severe abdominal pain at site of rupture +
    collapse.
  • Cessation of uterine contractions.
  • Feeling of something giving away.
  • Vaginal bleeding may be present.
37
Q

CP of Spontaneous Actual rupture during labor
- Signs

A
38
Q

CP of Spontaneous Actual rupture during labor

  • Genral Signs
A

Signs of hypovolemic shock

39
Q

CP of Spontaneous Actual rupture during labor

  • Abdominal Signs
A

As before but inaudible FHS is the commonest presentation.

40
Q

CP of Spontaneous Actual rupture during labor

  • Vaginal Signs
A
41
Q

CP of Traumatic Actual rupture during labor

A
42
Q

Clinical Types of Rupture Uterus

A
43
Q

Clinical Types of Rupture Uterus

  • silent Rupture
A
44
Q

Clinical Types of Rupture Uterus

  • Overt Rupture
A

è or èout shock.

45
Q

DDx of Rupture Uterus

A
  1. Advanced abdominal pregnancy.
  2. Concealed accidental Hge.
  3. Other causes of PPH.
  4. Other causes of intraperitoneal Hge (as rupture spleen).
46
Q

Prevention of Rupture Uterus

A
47
Q

TTT of Rupture Uterus

A
48
Q

TTT of Rupture Uterus

  • 1st Aid
A

…

49
Q

TTT of Rupture Uterus

  • Vaginal delivery?
A

No, Because it ↑↑ Hge, shock & extent of tear.

50
Q

TTT of Rupture Uterus

  • Laparotomy
A
51
Q

TTT of Rupture Uterus

  • Vaginal Repair
A

if there is extension of cervical tear to LUS è accessible upper end of tear.

Y4R2 - Obstetrics I 🤰 (52 decks)

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