Uterine rupture

Revision as of 20:50, 31 January 2013 by Kalsang Dolma (talk | contribs)
Jump to navigation Jump to search

Uterine Rupture Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Uterine Rupture from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Uterine rupture On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Uterine rupture

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Uterine rupture

CDC on Uterine rupture

Uterine rupture in the news

Blogs on Uterine rupture

Directions to Hospitals Treating Uterine rupture

Risk calculators and risk factors for Uterine rupture

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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.

Etiology

A uterine rupture typically occurs during early labor, but may already develop during late pregnancy. 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]

Clinical presentation

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. Often a deterioration of the fetal heart rate is a leading sign. Intraabdominal bleeding, of course, can lead to hypovolemic shock and death.

Treatment

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

  1. 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.


Template:WikiDoc Sources