In this article, we shall look at the risk factors, clinical features and management of uterine rupture. Fig 1 — Operative image of a complete uterine rupture.
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The amniotic sac is intact — this is unusual, as most cases of uterine rupture occur during labour. The risk factors for uterine rupture are generally those that make the uterus inherently weaker :. The initial clinical features of uterine rupture are non-specific , which makes diagnosis and prompt management difficult.
The most common presenting symptom is sudden severe abdominal pain , which persists between contractions. On examination, there may be regression of the presenting part, with abdominal palpation revealing scar tenderness and palpable fetal parts.
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Significant haemorrhage can produce signs of hypovolaemic shock ; such as tachycardia and hypotension. In women at risk of uterine rupture, intrapartum monitoring with cardiotocography is vital.
In many cases, a pathological CTG prompts an emergency section — with uterine rupture noted intra-operatively. Maternal haematuria may also be present on catheterisation.
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If there is a suspicion of uterine rupture in the pre-labour setting, ultrasound can be used for diagnosis. Features include abnormal fetal lie or presentation, haemoperitoneum and absent uterine wall.
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Uterine rupture is an obstetric emergency. Therefore, it is vital to first undertake an A-E approach, and call the appropriate staff — including senior obstetricians, midwives and anaesthetists, and, where appropriate, invoke the Massive Obstetric Haemorrhage protocol.
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The fetus is delivered by Caesarean section , and the uterus is either repaired or removed hysterectomy. In the UK, guidelines suggest that the decision-incision interval in operative intervention should be less than 30 minutes. Once you've finished editing, click 'Submit for Review', and your changes will be reviewed by our team before publishing on the site.
Copyright J. Trop J Obstet Gynaecol ; Trop Doct ; Rupture uterus in Ibadan, A twelve year review.
Uterine rupture signs, symptoms and causes
Int J Gynecol Obstet ; Uterine rupture in Sokoto, Northern Nigeria…. Afr J Med Sci ; Ghatak DP. Rupture of the uterus: A review of cases. Trop J Obstet Gynecol A ten year review of maternal mortality in Sokoto, Northern Nigeria. West Afr J Med ; Uterine rupture in a primigravida: A case report.
What Is a Uterine Rupture and How Often Does It Occur? | foanimarmawi.gq
Sahel Med J ; Ibekwe PC. Rupture uterus in a primigravida: A case report. Rupture uterus in a primigravida, Secondary to abdominal manipulation by a traditional birth attendance: A case report. Rupture of the pregnant uterus in an unbooked Primigravida: A case report.