Uterine Rupture

OVERVIEW

Uterine rupture is a rare but life-threatening complication that can occur during an attempted vaginal birth.

A uterine rupture is a self descriptive condition. It is a very serious complication given its nature (source)
A uterine rupture is a self descriptive condition. It is a very serious complication given its nature (source)
WHAT MAKES US SUSPECT IT?

Risk Factors:

Prior uterine surgery (cesarean section, myomectomy), induction of labor/prolonged labor, fetal macrosomia

Initial Presentation: This is a complication that will occur during attempted vaginal delivery (especially in patients with prior history of cesarean section). Some initial things that can be observed are:

  • Severe abdominal pain
  • Vaginal bleeding
  • Hypotension
  • Tachycardia
  • Fetal distress (fetal hear decelerations)
  • Loss of intrauterine pressure (easier to evaluate for with patients who have a n intrauterine pressure catheter).

Physical Exam:

Vital signs: can show signs of hemodynamic instability

  • Hypotension
  • Tachycardia
  • Elevated respiration rate

Abdominal exam:

  • Palpation of fetal parts OUTSIDE suspected area of uterus

Vaginal exam: 

  • Vaginal bleeding
  • No presenting fetal part
  • Loss of fetal station is a RED flag for uterine rupture (thought to be pathognomonic)

Fetal Heart Tracing

Fetal heart monitoring can reveal signs of hypoxia/distress

  • Tachycardia
  • Minimal variability
  • Late decelerations

 

Page Updated: 10.02.2016