Uterine Rupture

Question 1

Signs of impending uterine rupture

Answer 1

Severe abdominal pain

Increased contractions followed by hyperactive labor

Bandl ring: muscular ring that can be seen above the belly button due to the powerful contractions of the upper uterine segment

Question 2

Rupture commonly occurs in

Answer 2

Active stage of labor

Question 3

Diagnosis is made by

Answer 3

Hemoperitoneum (positive FAST)

Protrusion of amniotic sac

Endometrial or myometrial defect

Extrauterine hematoma

Question 4

Mgt includes

Answer 4

Avoid uterotonic agents.

If signs of imminent uterine rupture are present: Consider IV tocolytics in consultation with OB-GYN as a temporizing measure

Question 5

Uterine incompetence occurs

Answer 5

Usually less than 24 weeks

Question 6

Risk factors for Uterine incompetence

Answer 6

LEEP
Prior forceps
Provo surgery
Uterine anomalies
Genetics
Ehler dahlos syndrome

Question 7

Ehler dahlos syndrome

Answer 7

Defective cervical collagen

Question 8

Complications include

Answer 8

Chorioamnionitis
pRom

Question 9

Diagnosis of cervical insufficiency

Answer 9

Cervical shortening funneling dilation

Trans vaginal u/s

Question 10

cervical insufficiency mgt

Answer 10

Abdominal and cervical cerclage and cerclage removal at 36-38 weeks

Question 11

cervical insufficiency medication

Answer 11

Indomethacin for lung maturation
Progestin