Uterine rupture

Question 1

Definition

Answer 1

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

Question 2

Incomplete rupture

Answer 2

AKA uterine dehiscence, the uterine serosa (perimetrium) surrounding the uterus remains intact.

Question 3

Complete uterine 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 factors

Answer 4

• Vaginal birth after previous caesarean section = scar of the uterus becomes a point of weakness, and may rupture with excessive pressure (excessive stimulation by oxytocin)
• Previous uterine surgery
• Increased BMI
• High parity
• Increased age
• Induction of labour
• Use of oxytocin to stimulate contractions

Question 5

Signs and symptoms

Answer 5

Acutely unwell Px with abnormal CTG. May occur with induction or augmentation of labour +/-:
- Abdominal pain
- Vaginal bleeding
- Ceasing of uterine contractions
- Hypotension
- Tachycardia
- Collapse

Question 6

Management

Answer 6

Obstetric emergancy
- Resus and transfusion may be required.
- Emergency c-section necessary to remove baby and stop bleeding/ hysterectomy if necessary

Question 7

Complications

Answer 7

The baby may be released from the uterus into the peritoneal cavity
High mortality rate for mother and child