Uterine Rupture: Causes, Diagnosis, and Management

Introduction

Uterine rupture is a rare but serious obstetric complication that can result in life-threatening maternal and fetal outcomes. This article explores the causes, diagnosis, and management of uterine rupture, along with prevention strategies and obstetric considerations.

Causes of Uterine Rupture

Previous Cesarean Section: The most significant risk factor is a history of cesarean delivery, particularly if the uterine scar is weak.
Uterine Overdistension: Conditions such as polyhydramnios or multiple gestations can place excessive strain on the uterine wall.
Induced Labor: Use of uterotonic agents like oxytocin or prostaglandins increases uterine contractility, raising rupture risk.
Trauma: Accidental injuries, surgical procedures, or excessive force during labor can contribute to uterine rupture.

Diagnosis

Clinical signs of uterine rupture include sudden onset of abdominal pain, fetal distress, abnormal uterine contractions, and maternal hemodynamic instability. Ultrasound and MRI may aid in confirming the diagnosis.

Management Strategies

Immediate Surgical Intervention: An emergency laparotomy is often required to control hemorrhage and repair the uterine defect.
Hemodynamic Support: Blood transfusions and intravenous fluid resuscitation help stabilize the patient.
Fetal Care: In cases where fetal distress is noted, an immediate cesarean delivery is performed.

Prevention Strategies

Careful Monitoring of Labor: Proper fetal and maternal surveillance during labor reduces risk.
Elective Cesarean for High-Risk Cases: Women with previous uterine surgery or extensive risk factors may benefit from scheduled cesarean deliveries.
Educating Patients: Informing expectant mothers about warning signs and risk factors aids in early intervention.

Conclusion

Uterine rupture remains a significant obstetric emergency requiring prompt diagnosis and management. Early recognition and appropriate intervention are key to preventing severe complications.