Uterine rupture Flashcards
What is a uterine rupture?
A complication of labour, where the muscular layer of the uterus (myometrium) ruptures.
2 types of uterine ruptures?
Complete rupture
Incomplete rupture
What is an incomplete uterine rupture?
When the uterine serosa (perimetrium) surrounding the uterus remains intact.
What is a complete uterine rupture?
When the serosa ruptures along with the myometrium, and the contents of the uterus are released into the peritoneal cavity.
What is the main risk factor for uterine rupture?
Previous Caesarian section
It is extremely rare for uterine rupture to occur in a patient that is giving birth for the first time. True/false?
True
A previous C section poses a high risk since the scar on the uterus becomes a point of weakness, and may rupture with excessive pressure (e.g. excessive stimulation by oxytocin).
Apart from previous c-section, what are other risk factors to consider that may lead to uterine rupture?
Vaginal birth after caesarean (VBAC)
Previous uterine surgery
Increased BMI
High parity
Increased age
Induction of labour
Use of oxytocin to stimulate contractions
Main presentation of uterine rupture?
Uterine rupture presents with an acutely unwell mother and abnormal CTG.
Other additional presentations of uterine rupture?
May occur with induction or augmentation of labour, with signs and symptoms of:
Abdominal pain
Vaginal bleeding
Ceasing of uterine contractions
Hypotension
Tachycardia
Collapse (potential cardiac arrest)
Management of uterine rupture?
Uterine rupture is an 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 (hysterectomy).
