Uterine Rupture

Actual Image of Uterine Rupture

 

The Realm of Ruptured Uterus

Description

This condition usually occurs in about 1 of 1,500 births. It starts when the uterus undergoes more strain thay it is capable of sustaining and then ruptures. The impending rupture is usually preceded by a pathological retraction rin. The rupture can be complete, going through endometrium, myometrium, and peretoneum, or incomplete, leaving the peritoneum intact. The viability of the fetus depends on the extent of the rupture and the time that elapses between the rupture and abdominal extraction. A woman who have this condition will suffer from blood loss.

What Causes it?

Usually it occurs from a previous cesarean birth, such as when a vertical scar from a previous incision is present. It can also occur from hysterectomy repair. Below are the common causes of this condition:

1. Prolonged labor
2. Faulty presentation
3. Multiple gestation
4. Use of oxytocin
5. Obstructed labor
6. Traumatic maneuvers using forceps or traction

What to look for?

The indentation appearing across the abdomen over the uterus. The strong uterine contractions without any cervical dilation can also be an indication for this condition. Other clinical manifestations are:

1. Sudden, severe pain during a strong labor contraction
2. Tearing sensation
3. Cessation of uterine contraction
4. Hemorrhage
5. Signs of shock
6. Change in Abdominal contour with two distinct swellings
7. Retracted uterus
8. Extrauterine fetus
9. Absent of fetal heart sounds

How is it treated?

At the end of pregnancy the uterus is highly vascular organ making uterine rupture an immediate emergency situation, comparable to a splenic or hepatic rupture. The treatment focues on the following measures:

1. Fluid replacement
2. Intravenous administration of oxytocin to contract the uterus and minimize bleeding.
3. Cesarean birth, if possible, will be done to ensure safe birth of the fetus.
4. Manual removal of the placenta under the general anesthesia may be necessary in the event of placental-stage pathologic retraction rings.
5. It is inadvisable for a mother to conceive again after uterine rupture, unless it occured in the inactive lower segment.

How to Manage this Condition at Home?

1. If the following signs mentioned above where being manifested by the pregnant mother, it is best to contact the hospital for immediate transportation.
2. Immediately provide information to the support person and inform them about the fetal outcome, the extent of surgery, and the safety of the mother and her fetus.
3. Offer emotional support and expect them to grieve, not only for the loss of this child (if applicable) but also for the loss of having future children through pregnancies (if a hysterectomy or removal of the ovaries or tubal ligation is performed).
4. Allow them time to express their emotions without feeling threatened.