The article was consulted professionally by Doctor of Obstetrics and Gynecology Department – Share99 Central Park International Health Hub.
Rupture of the uterus is a very dangerous obstetric accident. Failure to detect and handle in time can be fatal for the mother and fetus. Rupture of the uterus during pregnancy is usually less common during labor.
1. What is rupture of the uterus during pregnancy?
Rupture of the uterus is a condition in which the uterus is torn from the mucosa through the muscle layer. Rupture of the uterus consists of 4 clinical er forms:
1.1 Complete rupture of the uterus
Rupture of the uterus is completely the entire thickness of the wall of the uterus is torn (mucous membranes, muscles to the mucous membranes). The tearing position is usually on the left side and the front of the segment under the uterus, the tear can extend from the cervical to the body of the uterus. In complete rupture of the uterus: pregnancy, the placenta of amniotic fluid is pushed into the mother's abdomen so it is prone to peritonitis.
1.2 Non-complete rupture of the uterus
This er erm is also known as rupture of the uterus under theitone membrane. Only the mucous layer and muscle layer are torn, the lower segmental mescosa is peeled off but has not yet been torn. Blood does not flow into the mother's abdomen but flows into the wide ligament forming a hematoma in the wide ligament, subframe. In case of rupture of the uterus is not completely pregnant and the vegetable remains in the uterus so the pregnancy may be alive.
1.3 Rupture of the uterus in humans with old surgical scars
Often due to scarring in the uterus ruptured or partly cracked, this case the banks of the lacerations are not lava and sometimes less bleeding.
1.4 Complex rupture
Lesions of a complex rupture of the uterus include complete rupture of the uterus with extensive lesions, which can extend down the vagina, tearing the same stricular, bladder or rupture of the uterus artery. Due to the complex injury, patients are often severely stunned, so the handling is very difficult and post-surgery is severe.
2. Causes of rupture of the uterus during pregnancy
Rupture of the uterus during pregnancy may occur on pregnant women with old surgical scars in the uterus due to:
- Cesarean section in the body of the uterus.
- Stitch up the ruptured uterus.
- Cesarean section is two or more times or more (scarring of the lower part of the uterus before, the more caesarean sections increase the risk of rupture of the uterus).
- Surgery to remove the angle of the uterus in the surgical treatment of extra-in-uterus in the horns.
- Cesarean section is infected at the incision or uterus.
- Uterine fibroid surgery (if uterine fibroids are inge in the endo willea).
- Stitching of the perforation of the uterus after abortion.
- Accidents, direct trauma.
3. Signs of rupture of the uterus during pregnancy
Rupture of the uterus during pregnancy can occur in the middle and last 3 months of pregnancy but there is no sign of a threat of rupture of the uterus.
- Pain occurs suddenly in the area of the uterus (usually in the old incision position).
- Bleeding in the vagina.
3.2 Symptoms of the whole body
In some cases the patient shows signs of dizziness, pale facial skin, rapid breathing, shallow breathing, cold limbs, sweating, rapid pulse, lowered blood pressure, sometimes cardiac arrest is possible.
3.3 Physical symptoms
- Abdominal pain: pain can spread throughout the abdomen, sometimes the peritoneal reaction is very clear.
- The uterus no longer has its original shape, it is possible to palpation of the fetal parts just below the abdominal wall, in case of rupture of the uterus it is not quite possible to palpation of the uterus but there is a point of glare in the scarring area of the uterus.
- Listen to the pregnancy heart: The pregnant heart is no longer heard.
- Abdominal knock: The abdomen is completely opaque.
- Vaginal examination: The pregnancy is not palpable, there is blood coming out with the hands.
Attention: There are cases of old surgical scars cracking, so there are no typical signs of internal bleeding as described above.
- Ultrasound if the uterus ruptures completely will be seen in the abdomen there are: Fetus, non-beating fetal heart, epidemic.
- Test: In blood tests there is a decrease in the number of red blood cells, hemoglobin (Hb) and hematocrit (Hct). Red blood cells, Hb, Hct are much reduced in case of severe blood loss.
4. Prevention of rupture of the uterus during pregnancy
Prevention plays a very important role in lowering the incidence of rupture of the uterus, mortality from rupture of the uterus.
- During pregnancy: Regular pregnancy examination is required, early detection of difficulties such as narrow pelvis, distorted pelvis, old surgical scars in the uterus, large pregnancy, abnormal corn …
- Communes and districts that are unable to operate are not allowed to manage difficult births but have to move to the upline for management.
- Women with scarring in the uterus must be admitted to the hospital before labor for careful monitoring and timely intervention.
If there are abnormal signs and there are abdominal pains or abnormal bleeding in the vagina, you should go to the doctor immediately so that you can detect and handle possible complications in a timely manner.
Rupture of the uterus is a very dangerous obstetric accident. Failure to detect and handle in time can be fatal for the mother and fetus. Therefore, when there are risk factors of rupture of the uterus, the pregnant women should be closely monitored by doctors.
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