Uterine rupture

Uterine rupture is a potentially catastrophic event during childbirthby which the integrity of the myometrialwall is breached. In an incomplete rupture the peritoneumis still intact. With a complete rupture the contents of the uterus may spill into the peritoneal cavity or the broad ligament. A uterine rupture is a life-threatening event for mother and baby.

A uterine rupture typically occurs during early labor, but may already develop during late pregnancy. A uterine scar from a previous cesarean sectionis the most common risk factor. Other forms of uterine surgery that result in full-thickness incisions (such as a myomectomy), dysfunctional labor, labor augmentation by oxytocinor prostaglandins, and high paritymay also set the stage for uterine rupture.

Symptoms of a rupture may be initially quite subtle. An old cesarean scar may undergo dehiscence, but with further labor, the paturient may experience abdominal pain and vaginal bleeding. Often a deterioration of the fetal heart rate is a leading sign. Intraabdominal bleeding, of course, can lead to hypovolemic shockand death.

Emergency exploratory laparotomywith cesarean delivery accompanied by fluid and blood transfusionare indicated for the management of uterine rupture. Depending on the nature of the rupture and the condition of the patient the uterus may be either repaired or needs to be removed (cesarean hysterectomy).

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It uses material from the Wikipedia article Uterine rupture.