Uterine rupture: Difference between revisions
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{{Short description|A serious childbirth complication}} | {{SI}} {{Infobox medical condition | ||
| name = Uterine rupture | |||
| image = [[File:Rupture_Tranverse.jpg|250px]] | |||
| caption = Transverse uterine rupture | |||
| field = [[Obstetrics]] | |||
| synonyms = | |||
| symptoms = Abnormal [[fetal heart rate]], [[abdominal pain]], [[vaginal bleeding]], [[hypotension]] | |||
| complications = [[Fetal distress]], [[hemorrhage]], [[hysterectomy]], [[maternal death]] | |||
| onset = During [[labor]] | |||
| duration = | |||
| types = [[Complete uterine rupture]], [[incomplete uterine rupture]] | |||
| causes = [[Previous cesarean section]], [[trauma]], [[induction of labor]] | |||
| risks = [[Multiple pregnancies]], [[uterine overdistension]], [[prolonged labor]] | |||
| diagnosis = [[Ultrasound]], [[fetal monitoring]], [[clinical examination]] | |||
| differential = [[Placental abruption]], [[preterm labor]], [[appendicitis]] | |||
| prevention = [[Trial of labor after cesarean]] (TOLAC) in appropriate candidates, careful monitoring during labor | |||
| treatment = [[Emergency cesarean section]], [[blood transfusion]], [[surgical repair]] | |||
| medication = | |||
| prognosis = Depends on promptness of treatment | |||
| frequency = Rare | |||
| deaths = | |||
}} | |||
[[Category:Obstetrics]] | |||
[[Category:Medical emergencies]] | |||
[[Category:Pregnancy complications]]{{Short description|A serious childbirth complication}} | |||
{{Medical condition (new)}} | {{Medical condition (new)}} | ||
'''Uterine rupture''' is a serious obstetric complication where the muscular wall of the [[uterus]] tears during [[pregnancy]] or [[childbirth]]. This condition can lead to severe maternal and fetal morbidity and mortality if not promptly diagnosed and managed. | '''Uterine rupture''' is a serious obstetric complication where the muscular wall of the [[uterus]] tears during [[pregnancy]] or [[childbirth]]. This condition can lead to severe maternal and fetal morbidity and mortality if not promptly diagnosed and managed. | ||
==Pathophysiology== | ==Pathophysiology== | ||
Uterine rupture typically occurs during [[labor]] and is often associated with a previous [[cesarean section]] scar. The rupture can be complete, involving all layers of the uterine wall, or incomplete, where the peritoneum remains intact. The most common site for rupture is the lower uterine segment. | Uterine rupture typically occurs during [[labor]] and is often associated with a previous [[cesarean section]] scar. The rupture can be complete, involving all layers of the uterine wall, or incomplete, where the peritoneum remains intact. The most common site for rupture is the lower uterine segment. | ||
==Risk Factors== | ==Risk Factors== | ||
Several factors increase the risk of uterine rupture, including: | Several factors increase the risk of uterine rupture, including: | ||
| Line 14: | Line 35: | ||
* Trauma to the uterus | * Trauma to the uterus | ||
* Congenital uterine anomalies | * Congenital uterine anomalies | ||
==Clinical Presentation== | ==Clinical Presentation== | ||
The symptoms of uterine rupture can vary but often include: | The symptoms of uterine rupture can vary but often include: | ||
| Line 22: | Line 42: | ||
* Abnormal fetal heart rate patterns | * Abnormal fetal heart rate patterns | ||
* Maternal tachycardia and hypotension | * Maternal tachycardia and hypotension | ||
==Diagnosis== | ==Diagnosis== | ||
Diagnosis is primarily clinical, supported by [[ultrasound]] findings. In some cases, a sudden change in the fetal heart rate pattern may be the first indication of a rupture. | Diagnosis is primarily clinical, supported by [[ultrasound]] findings. In some cases, a sudden change in the fetal heart rate pattern may be the first indication of a rupture. | ||
==Management== | ==Management== | ||
Immediate surgical intervention is required to manage uterine rupture. This typically involves an emergency [[laparotomy]] and repair of the uterine defect or [[hysterectomy]] if repair is not feasible. Rapid delivery of the fetus is crucial to minimize fetal and maternal complications. | Immediate surgical intervention is required to manage uterine rupture. This typically involves an emergency [[laparotomy]] and repair of the uterine defect or [[hysterectomy]] if repair is not feasible. Rapid delivery of the fetus is crucial to minimize fetal and maternal complications. | ||
==Prognosis== | ==Prognosis== | ||
The prognosis depends on the speed of diagnosis and intervention. Prompt surgical management can significantly reduce the risk of severe outcomes for both the mother and the fetus. | The prognosis depends on the speed of diagnosis and intervention. Prompt surgical management can significantly reduce the risk of severe outcomes for both the mother and the fetus. | ||
==Prevention== | ==Prevention== | ||
Preventive strategies include careful monitoring of labor in women with a history of cesarean delivery and avoiding unnecessary induction of labor. Elective repeat cesarean delivery may be recommended for women at high risk of rupture. | Preventive strategies include careful monitoring of labor in women with a history of cesarean delivery and avoiding unnecessary induction of labor. Elective repeat cesarean delivery may be recommended for women at high risk of rupture. | ||
==See also== | |||
== | |||
* [[Cesarean section]] | * [[Cesarean section]] | ||
* [[Labor (childbirth)]] | * [[Labor (childbirth)]] | ||
* [[Obstetrics]] | * [[Obstetrics]] | ||
* [[Maternal health]] | * [[Maternal health]] | ||
[[Category:Obstetrics]] | [[Category:Obstetrics]] | ||
[[Category:Medical emergencies]] | [[Category:Medical emergencies]] | ||
Latest revision as of 06:42, 6 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics
| Uterine rupture | |
|---|---|
| File:Rupture Tranverse.jpg | |
| Synonyms | |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Abnormal fetal heart rate, abdominal pain, vaginal bleeding, hypotension |
| Complications | Fetal distress, hemorrhage, hysterectomy, maternal death |
| Onset | During labor |
| Duration | |
| Types | Complete uterine rupture, incomplete uterine rupture |
| Causes | Previous cesarean section, trauma, induction of labor |
| Risks | Multiple pregnancies, uterine overdistension, prolonged labor |
| Diagnosis | Ultrasound, fetal monitoring, clinical examination |
| Differential diagnosis | Placental abruption, preterm labor, appendicitis |
| Prevention | Trial of labor after cesarean (TOLAC) in appropriate candidates, careful monitoring during labor |
| Treatment | Emergency cesarean section, blood transfusion, surgical repair |
| Medication | |
| Prognosis | Depends on promptness of treatment |
| Frequency | Rare |
| Deaths | |
A serious childbirth complication
Template:Medical condition (new)
Uterine rupture is a serious obstetric complication where the muscular wall of the uterus tears during pregnancy or childbirth. This condition can lead to severe maternal and fetal morbidity and mortality if not promptly diagnosed and managed.
Pathophysiology[edit]
Uterine rupture typically occurs during labor and is often associated with a previous cesarean section scar. The rupture can be complete, involving all layers of the uterine wall, or incomplete, where the peritoneum remains intact. The most common site for rupture is the lower uterine segment.
Risk Factors[edit]
Several factors increase the risk of uterine rupture, including:
- Previous cesarean delivery
- Induction of labor with oxytocin or prostaglandins
- High parity (having given birth multiple times)
- Trauma to the uterus
- Congenital uterine anomalies
Clinical Presentation[edit]
The symptoms of uterine rupture can vary but often include:
- Sudden onset of abdominal pain
- Vaginal bleeding
- Loss of fetal station
- Abnormal fetal heart rate patterns
- Maternal tachycardia and hypotension
Diagnosis[edit]
Diagnosis is primarily clinical, supported by ultrasound findings. In some cases, a sudden change in the fetal heart rate pattern may be the first indication of a rupture.
Management[edit]
Immediate surgical intervention is required to manage uterine rupture. This typically involves an emergency laparotomy and repair of the uterine defect or hysterectomy if repair is not feasible. Rapid delivery of the fetus is crucial to minimize fetal and maternal complications.
Prognosis[edit]
The prognosis depends on the speed of diagnosis and intervention. Prompt surgical management can significantly reduce the risk of severe outcomes for both the mother and the fetus.
Prevention[edit]
Preventive strategies include careful monitoring of labor in women with a history of cesarean delivery and avoiding unnecessary induction of labor. Elective repeat cesarean delivery may be recommended for women at high risk of rupture.