Rotura Uterina

Question 1

What is rotura uterina?

Answer 1

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.

Question 2

What is the frequency of rotura uterina in cases without previous cesarean?

Answer 2

1/5,700 to 1/20,000

This indicates that it is a rare occurrence.

Question 3

What part of the uterus is most commonly affected by rotura uterina?

Answer 3

The lower uterine segment

This is where most ruptures are observed.

Question 4

What are the two types of rotura uterina?

Answer 4

• Completa
• Incompleta

Completa includes all layers and membranes; incompleta preserves the peritoneum visceral.

Question 5

What is the main risk factor for rotura uterina?

Answer 5

Previous cesarean section

Especially if the previous incision was longitudinal or inverted T.

Question 6

Name other risk factors for rotura uterina.

Answer 6

• 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.

Question 7

What is the most common clinical manifestation of rotura uterina?

Answer 7

Fetal bradycardia

This may be preceded by late or variable decelerations.

Question 8

What symptoms suggest rotura uterina?

Answer 8

• Constant abdominal pain
• Hemodynamic changes

Pain may be partially masked by analgesia.

Question 9

True or False: There is a specific pathognomonic sign for rotura uterina.

Answer 9

False

No single sign can definitively indicate uterine rupture.

Question 10

Fill in the blank: The type of uterine rupture that conserves the peritoneum visceral is called _______.

Answer 10

incompleta

This distinguishes it from complete rupture.

Question 11

What should alert us in postpartum women with a previous uterine scar?

Answer 11

The persistence of considerable vaginal bleeding despite uterotonics.

Question 12

What is the basis for diagnosis and management in suspected uterine rupture?

Answer 12

It is based on clinical findings and requires a high index of suspicion if the patient has risk factors.

Question 13

How is a definitive diagnosis of uterine rupture made?

Answer 13

Through laparotomy.

Question 14

What is the treatment of choice upon suspicion of uterine rupture?

Answer 14

Immediate fetal extraction via urgent laparotomy, ensuring maternal stability and volume replacement.

Question 15

What are the surgical objectives in managing uterine rupture?

Answer 15

Control of bleeding, identification and repair of possible damage to other organs, and minimization of postoperative morbidity.

Question 16

What factors influence the decision between uterine repair or hysterectomy?

Answer 16

Factors include the patient’s desire for future pregnancies, hemodynamic stability, extent of the injury, degree of hemorrhage, and the obstetrician’s surgical skill.

Question 17

What is contraindicated after a uterine rupture?

Answer 17

Vaginal delivery in subsequent pregnancies.

Question 18

What is recommended regarding the timing of cesarean delivery after a uterine rupture?

Answer 18

It is recommended to complete the pregnancy at term to minimize neonatal morbidity, unless there are high-risk factors for rupture.

Question 19

What imaging techniques have been attempted to predict the risk of recurrence in future pregnancies?

Answer 19

Abdominal ultrasound and magnetic resonance imaging (MRI).

Question 20

Is the estimation of recurrence risk in future pregnancies clearly indicated in clinical practice?

Answer 20

No, it remains a complicated parameter to calculate and is not clearly indicated in clinical practice.

Question 21

Can imaging tests be useful in decision-making regarding future pregnancies?

Answer 21

Yes, they may be useful in the decision-making process.