Rupture of the Uterus

Rupture of the Uterus

Uterine rupture is the catastrophic tearing open of the uterus into the abdominal cavity, most commonly during labour and delivery. It is an obstetrical emergency which puts the life of both the pregnant woman and her baby at risk.

In order to understand uterine rupture, it is useful to consider the structure and function of the uterus. The uterus has muscular walls.  This allows the uterus to increase in size during pregnancy and to create room for the growing baby. The walls also become thinner with this process and, rarely, this means that it can tear.  There are some pregnant women who are more at risk of uterine rupture than others.

The risk factors for uterine rupture include:

  • Those who have had previous surgery on their uterus including a previous caesarean section (most common risk factor);
  • Those with a uterus which has an atypical shape (i.e. undeveloped uterine horn);
  • Those with a history of a condition where their placenta was strongly adherent to the wall of the uterus (placental accrete, increta and percreta);
  • Those who have had a difficult forceps delivery in the past;
  • Those who have induction of labour with oxytocin; and
  • Those who have an abnormal contraction pattern during labour.
There are some classic warning signs and symptoms of an impending uterine rupture. If these signs or symptoms are present, especially in the context of the risk factors described above, it is critical that the pregnant woman receive prompt medical attention and urgent delivery of her baby. In this setting, minutes matter and it is important for the safety of the pregnant woman and her baby that there is no delay in delivering the baby.

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