Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Uterine rupture
Introduction
Overview
Overview
Uterine rupture is a potentially catastrophic event during childbirth by which the integrity of the myometrial wall is breached. In an incomplete rupture the peritoneum is 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.
Causes
A uterine rupture typically occurs during early labor, but may already develop during late pregnancy.
Risk Factors
A uterine scar from a previous cesarean section is 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 oxytocin or prostaglandins, and high parity may also set the stage for uterine rupture. In 2006, an extremely rare case of uterine rupture in a first pregnancy with no risk factors was reported.[1]
Diagnosis
History and Symptoms
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.
Physical Examination
Often a deterioration of the fetal heart rate is a leading sign. Intraabdominal bleeding, of course, can lead to hypovolemic shock and death.
Treatment
Surgery
Emergency exploratory laparotomy with cesarean delivery accompanied by fluid and blood transfusion are 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).
References
- ↑ Walsh CA, O’Sullivan RJ, Foley ME (2006). “Unexplained prelabor uterine rupture in a term primigravida”. Obstetrics and gynecology. 108 (3 Pt 2): 725–7. doi:10.1097/01.AOG.0000195065.38149.11. PMID 17018479.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Historical Perspective
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References
Classification
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References
Pathophysiology
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References
Causes
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Overview
A uterine rupture typically occurs during early labor, but may already develop during late pregnancy.
References
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Differentiating Uterine Rupture from other Diseases
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References
Epidemiology and Demographics
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References
Risk Factors
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Overview
A uterine scar from a previous cesarean section is 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 oxytocin or prostaglandins, and high parity may also set the stage for uterine rupture. In 2006, an extremely rare case of uterine rupture in a first pregnancy with no risk factors was reported.[1]
References
- ↑ Walsh CA, O’Sullivan RJ, Foley ME (2006). “Unexplained prelabor uterine rupture in a term primigravida”. Obstetrics and gynecology. 108 (3 Pt 2): 725–7. doi:10.1097/01.AOG.0000195065.38149.11. PMID 17018479.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Natural History, Complications and Prognosis
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References
Diagnosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies
Treatment
Treatment
Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]