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Uterine rupture during pregnancy - Causes, Symptoms & Treatments

Uterine rupture is a rupture in pregnancy and is a very rare condition which may happen in 0.07% - 0.08% cases only. Still, it is necessary to understand the reason, the probable symptoms and methods to treat it safely. The uterus is a 3 layered stretchable bag like, located in the abdominal cavity. The thin inner layer called endometrium, the middle layer of muscles and gives strength to the wall and the outermost layer called serosa or the peritoneum which is a very thin envelope-like barrier separates the uterus from the abdominal cavity.

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Uterine rupture is a tear in the Uterine wall. Observed in the last trimester of pregnancy and can cause maternal and foetal distress. It occurs when the uterine wall tears and the content ( foetus, placenta and umbilical cord) collapse of the mother are expelled out.

However, the contents always need not be expelled out. Mere rupture at times can cause profuse bleeding leading to collapse of mother and severe fetal distress.

The leading cause is scar rupture following a previous C-section. The rupture can be caused due to an upper segment C-section which can be without an onset of labor pain. Even the lower segment C-sections lead to rupture but rather late.  Other reasons are any surgery done on uterus like  D&C fibroid surgery correction of uterine anomalies and others.

  • Several successful deliveries in short intervals result in progressive thinning of uterine wall hence increase the risk of rapture
  • Obstructed labour- when the labour is aborted and a C section is done when the doctor realizes that the birth canal is too small for the baby to be born
  • Neglected labour- lack of access to medical care
  • Malpresentation- different body part appear first instead of the head causing uneven pressure on the uterus
  • Labour induction and augmentation using labour enhancing drugs
  • Congenital abnormality of the uterus
  • High maternal age- older mother is more prone than younger ones
  • Twins
  • Size of the baby is more than 4 kgs
  • Gestation age exceeding 40 weeks

Must Read: Placenta Previa: Causes, Risk, & Treatment

Sign and symptoms

  • Foetal distress - Abnormalities in foetal heart rate as measured by an electronic monitor, this is the most important sign and is present in 79-89% of the patient with uterine rupture.
  • Lesser intensity contraction or no feeling of uterine contraction
  • Sharp onset of pain at the sight of the previous scar
  • Excessive vaginal bleeding
  • Dizziness and loss of consciousness
  • Sliding back of the baby with the uterus

These are indicative symptoms, and proper diagnoses by experts are required to confirm it.

Timely diagnosis and commencement of treatment as quickly as possible to prevent complications

It is necessary to stabilize the mother, the foetus should be delivered within 10 to 37 minutes of rapture to avoid further complications to both mother and child. The newborn baby may require neonatal intensive care unit admission and observation. This may also require surgical intervention.

It is better to take preventive steps to minimize the risk:

  • Pregnancy before 30 years
  • Have natural delivery as far as possible
  • The spacing of at least 2 years between 2 births, especially in case of cesarean section
  • Immediately consult your doctor when something unusual is felt
  • Take the advice of your doctor

Must Read: VBAC – What It Is and What it Takes One to Attempt it

Doctors too should take the following precautions:

  • Identify high-risk cases
  • Do an MRI and try to predict the event
  • Counsel and inform the mother about the following condition

  • Closely monitor foetal heart rate and foetal activity
  • Depending on the risk factor take a timely decision on whether to conduct a trial of labor or opt for C section

Best way to avoid uterine rupture is by being aware and alert.

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