Uterine Rupture: Causes, Diagnosis, and Management

Definition and Classification of Uterine Rupture

Uterine rupture is a rare but severe obstetric complication characterized by the tearing of the uterine wall. It can lead to significant maternal and fetal morbidity and mortality. Uterine rupture is classified into complete and incomplete rupture:

Complete rupture: Full-thickness disruption of the uterine wall, including the serosa.
Incomplete rupture: Partial disruption where the serosa remains intact.

Causes of Uterine Rupture

Several factors contribute to uterine rupture, including:

Previous cesarean section or uterine surgery
Prolonged labor and obstructed labor
Excessive uterine stimulation with oxytocin or prostaglandins
Congenital uterine anomalies
Trauma or external force

Diagnosis of Uterine Rupture

Early diagnosis is crucial for preventing complications. Common clinical signs include:

Sudden onset of severe abdominal pain
Fetal distress or abnormal fetal heart rate patterns
Vaginal bleeding
Loss of uterine contractions
Palpable fetal parts outside the uterus

Management of Uterine Rupture

Management depends on the severity and timing of the rupture:

Immediate surgical intervention: Emergency laparotomy and repair or hysterectomy.
Resuscitation: Fluid replacement, blood transfusion, and stabilization of maternal vitals.
Fetal management: Urgent delivery to prevent fetal hypoxia.