Rotura Uterina Flashcards
What is rotura uterina?
Solution of continuity of the uterine wall in a pregnant uterus, excluding surgical perforations
It is an obstetric emergency that can lead to maternal or fetal death.
What is the frequency of rotura uterina in cases without previous cesarean?
1/5,700 to 1/20,000
This indicates that it is a rare occurrence.
What part of the uterus is most commonly affected by rotura uterina?
The lower uterine segment
This is where most ruptures are observed.
What are the two types of rotura uterina?
- Completa
- Incompleta
Completa includes all layers and membranes; incompleta preserves the peritoneum visceral.
What is the main risk factor for rotura uterina?
Previous cesarean section
Especially if the previous incision was longitudinal or inverted T.
Name other risk factors for rotura uterina.
- Previous uterine rupture
- Trauma
- Myometrial weakness
- Abdominal myomectomy history
- Advanced maternal age
- Fetal macrosomia
- High parity
- Multiple gestations
- Short intergenetic period
These factors can increase the likelihood of rupture during pregnancy or labor.
What is the most common clinical manifestation of rotura uterina?
Fetal bradycardia
This may be preceded by late or variable decelerations.
What symptoms suggest rotura uterina?
- Constant abdominal pain
- Hemodynamic changes
Pain may be partially masked by analgesia.
True or False: There is a specific pathognomonic sign for rotura uterina.
False
No single sign can definitively indicate uterine rupture.
Fill in the blank: The type of uterine rupture that conserves the peritoneum visceral is called _______.
incompleta
This distinguishes it from complete rupture.
What should alert us in postpartum women with a previous uterine scar?
The persistence of considerable vaginal bleeding despite uterotonics.
What is the basis for diagnosis and management in suspected uterine rupture?
It is based on clinical findings and requires a high index of suspicion if the patient has risk factors.
How is a definitive diagnosis of uterine rupture made?
Through laparotomy.
What is the treatment of choice upon suspicion of uterine rupture?
Immediate fetal extraction via urgent laparotomy, ensuring maternal stability and volume replacement.
What are the surgical objectives in managing uterine rupture?
Control of bleeding, identification and repair of possible damage to other organs, and minimization of postoperative morbidity.
What factors influence the decision between uterine repair or hysterectomy?
Factors include the patient’s desire for future pregnancies, hemodynamic stability, extent of the injury, degree of hemorrhage, and the obstetrician’s surgical skill.
What is contraindicated after a uterine rupture?
Vaginal delivery in subsequent pregnancies.
What is recommended regarding the timing of cesarean delivery after a uterine rupture?
It is recommended to complete the pregnancy at term to minimize neonatal morbidity, unless there are high-risk factors for rupture.
What imaging techniques have been attempted to predict the risk of recurrence in future pregnancies?
Abdominal ultrasound and magnetic resonance imaging (MRI).
Is the estimation of recurrence risk in future pregnancies clearly indicated in clinical practice?
No, it remains a complicated parameter to calculate and is not clearly indicated in clinical practice.
Can imaging tests be useful in decision-making regarding future pregnancies?
Yes, they may be useful in the decision-making process.
