Uterine Rupture

Question 1

Uterine rupture

Answer 1

Complication of labour, where the muscle layer of the uterus (myometrium) ruptures

Question 2

Uterine dehiscence

Answer 2

Incomplete rupture where the uterine serosa (perimetrium) surrounding the uterus remains intact

Question 3

Complete rupture

Answer 3

The serosa ruptures along with the myometrium, and the contents of the uterus are released into the peritoneal cavity

Question 4

Risk of complete uterine rupture

Answer 4

Significant bleeding.

The baby may be released from the uterus into the peritoneal cavity.

High morbidity and mortality for both the baby and mother

Question 5

Risk factors for uterine rupture

Answer 5

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

Question 6

Presentation of uterine rupture

Answer 6

Acutely unwell mother
Abnormal CTG

Abdominal pain
Vaginal bleeding
Ceasing of uterine contractions
Hypotension
Tachycardia
Collapse

Question 7

Management of uterine rupture

Answer 7

Obstetric emergency

Resuscitation and transfusion may be required

Emergency caesarean section is necessary to remove the baby, stop any bleeding and repair or remove the uterus