Uterine Rupture Flashcards
1
Q
What is uterine rupture?
A
- it is a complication of labour
- the myometrium (muscle layer of the uterus) ruptures
- it can be incomplete or complete
2
Q
What occurs in an incomplete uterine rupture?
A
- the myometrium is ruptured
- the uterine serosa (perimetrium) remains intact
- the serosa is the layer coating the outside of the uterus
this is also called “uterine dehiscence”
3
Q
What occurs in a complete uterine rupture?
A
- both the serosa and myometrium are ruptured
- the contents of the uterus are released into the peritoneal cavity
4
Q
What is the most acute feature of uterine rupture?
A
- significant bleeding
- the baby may be released from the uterus into the peritoneal cavity
- this has high morbidity / mortality for the mother + fetus
5
Q
What is the main risk factor for uterine rupture?
A
previous C-section
- the scar on the uterus is a point of weakness
- the scar may rupture with excessive pressure
it is very rare for uterine rupture to occur in a patient who is giving birth for the first time
6
Q
What are the other risk factors to consider in uterine rupture?
A
- VBAC
- previous uterine surgery
- increased BMI
- high parity
- increased age
- IOL and use of oxytocin to stimulate contractions
7
Q
What is the general presentation of uterine rupture?
A
- the mother is acutely unwell + there is an abnormal CTG
- this may occur with induction or augmentation of labour
8
Q
What are the physical symptoms of uterine rupture?
A
- severe abdominal pain that persists between contractions
- acute onset of scar tenderness
- abnormal vaginal bleeding / haematuria
- cessation of previously efficient contractions
- loss of station of presenting part
- hypotension, tachycardia, collapse
9
Q
What is the management for uterine rupture?
A
- emergency C-section is required to remove the baby
- hysterectomy may be required
- resuscitation and transfusion as necessary
this is an obstetric emergency
