Presentation
During the first stage of labour, suspicious CTG was present in approximately half of the tracings from both cases and controls (Table 3). Likewise, a pathological CTG was present in 41 (77%) of the cases and 23 (53%) of the controls. [journals.plos.org]
The study presents the case of a multigravida patient, with high risk for compensated gestational diabetes, and uncontrolled protein S deficiency. [scielo.org.co]
Features include abnormal fetal lie or presentation, haemoperitoneum and absent uterine wall. Management Uterine rupture is an obstetric emergency. [teachmeobgyn.com]
Here we report a spontaneous rupture of unscarred uterus with delayed presentation and without any usual risk factors. A 33-year-old and 38 weeks pregnant woman presented with regular uterine contractions. [dergipark.org.tr]
Most cases present with maternal tachycardia, signs of fetal distress, and bleeding. The treatment for intrapartum uterine rupture includes fluid resuscitation and emergency laporotomy. [typeset.io]
Entire Body System
- Asymptomatic
Other disruptions of the prior uterine scar were considered asymptomatic dehiscences. [journals.lww.com]
All uterine scar disruptions, which included both symptomatic ruptures and detected asymptomatic dehiscences, were analyzed together, and ruptures were examined separately. [typeset.io]
It is usually asymptomatic and does not require emergency surgery. Complete rupture can be: Traumatic: A road traffic collision. Incorrect use of oxytocic agent. [patient.info]
[…] again to a position of caution.1 Accordingly, the American College of Obstetricians and Gynecologists (ACOG) has revised its guidelines for VBAC and now recommends a more careful approach.2 Incidence True uterine rupture is typically distinguished from asymptomatic [aafp.org]
However, Chauhan et al observed a 9% rate of asymptomatic uterine scar dehiscence (95% CI, 5-15%). [31] This result suggests that disruptions of uterine scars might have been misclassified as true ruptures instead of dehiscences in previous studies; this [reference.medscape.com]
- Weakness
The theory has been that because there was no confined weak area, such as a previous incision, the tear may progress and involve vital, adjacent organs, leading to more serious complications. [oatext.com]
Gastrointestinal
- Severe Abdominal Pain
The most common presenting symptom is sudden severe abdominal pain, which persists between contractions. The patient may also experience shoulder-tip pain (from diaphragmatic irritation) and/or vaginal bleeding. [teachmeobgyn.com]
Severe abdominal pain changing so that it persists between contractions. Chest or shoulder tip pain and sudden shortness of breath. Scar pain and tenderness. Abnormal vaginal bleeding or gross haematuria. [patient.info]
- Lower Abdominal Pain
Shortly after delivering the placenta, she complained of severe lower abdominal pain with shock vitals. Exploratory laparotomy revealed a partial and shallow myometrial and serosal tear with massive hemoperitoneum. [tandfonline.com]
Psychiatrical
- Fear
One third of ruptures in patients with a previous classic uterine incision occur before the onset of labor.7,9 Despite initial fears that epidural anesthesia would mask the pain of uterine rupture, recent evidence shows that use of this anesthesia during [aafp.org]
Breech babies are now delivered by caesarian sections since the publication of the Term Breech Trial [2], and the rate of instrumental deliveries has decreased over the years due to a reduction in training hours, lack of senior supervision and fear of [oatext.com]
Neurologic
- Confusion
VBAC and now recommends a more careful approach.2 Incidence True uterine rupture is typically distinguished from asymptomatic scar separation (dehiscence) by the need for emergency surgery, although some reports combine these separate processes and confuse [aafp.org]
- Dizziness
You may also experience a drop in blood pressure, an increased heart rate, dizziness or shortness of breath. Baby’s heartbeat may also drop, which will appear on the fetal monitor. Some women, however, won’t notice any symptoms of uterine rupture. [whattoexpect.com]
Workup
Cardiology referral was made and cardiac workup was done. She was noted to be tachycardic and hypotensive about 4 hours later. Clinical examination revealed a tender central abdomen with guarding and minimal per vaginal bleeding. [oatext.com]
Treatment
Cesarean section and hysterectomy were performed as emergency surgical treatments due to uterine atony without bleeding control with pharmacological maneuvers. [scielo.org.co]
Treatment[edit] Emergency exploratory laparotomy with cesarean delivery accompanied by fluid and blood transfusion are indicated for the management of uterine rupture. [en.wikipedia.org]
Treatment of uterine rupture is immediate laparotomy with cesarean delivery and, if necessary, hysterectomy. Click here for Patient Education NOTE: This is the Professional Version. [msdmanuals.com]
Abstract Uterine ruptures typically occur suddenly, have obvious symptoms, and may require urgent treatment. We experienced a case of complete rupture of an unscarred uterus that was undetected for 9 days. [obgyn.onlinelibrary.wiley.com]
A high index of suspicion is crucial in timely diagnosis and treatment and preventing serious maternal morbidity and mortality. [oatext.com]
Prognosis
[…] onset During labor[3] Risk factors Vaginal birth after cesarean section, other uterine scars, obstructed labor, induction of labor, trauma, cocaine use[1][4] Diagnostic method Supported by a rapid drop in the baby’s heart rate[1] Treatment Surgery[1] Prognosis [en.wikipedia.org]
Prognosis[5] 6.2% of uterine ruptures are associated with perinatal (infant) death. 14-33% of women with uterine rupture require an emergency hysterectomy. [patient.info]
Etiology
[…] and T-shaped uterine incisions are reported to rupture in 4 to 9 percent of cases, while low-vertical incisions carry a rupture risk of 1 to 7 percent.2 In comparison, rupture of an unscarred uterus occurs in one of 8,000 to 17,000 deliveries.3,23,24 Etiology [aafp.org]
Epidemiology
Epidemiology Incidence Uterine rupture occurs extremely rarely - according to one study from the Netherlands, the incidence is between 0.7 and 5.1 per 10,000 deliveries in unscarred and scarred uteri, respectively[2]. [patient.info]
R.), the Department of Epidemiology, School of Public Health and Community Medicine (V.L.H.), the Department of Obstetrics and Gynecology, School of Medicine (T.R.E.), and the Department of Health Services, School of Public Health and Community Medicine [nejm.org]
Prevention
Can uterine rupture be prevented? The only way to prevent uterine rupture is to have a cesarean delivery. It can’t be fully prevented during vaginal birth. A uterine rupture shouldn’t stop you from choosing vaginal birth. [healthline.com]
Prevention of poor outcomes depends on thorough anticipation and preparation. The physicians and the delivery institution should be prepared to provide emergency surgical and neonatal care in the event of uterine rupture. [aafp.org]
A high index of suspicion is crucial in timely diagnosis and treatment and preventing serious maternal morbidity and mortality. [oatext.com]
Prevention Unfortunately, uterine rupture cannot be adequately predicted for women wanting a trial of labour following a previous caesarean section[7]. [patient.info]