uterine rupture

shutterstock 25605817Pregnant

The uterine rupture is one of the most feared complications of obstetric pregnancy, and may lead to life-threatening for both the fetus and for the mother. In the literature there are reports that the incidence may reach a uterine rupture every 2000 births. Important to note that this complication occurs not only during the stage of labor, uterine rupture can occur during pregnancy. In this way, the main risk factor is a large number of previous births, known in the medical field as multiparity.

Risk factors

Other risk factors associated with this complication that could be cited are: previous uterine surgery, for example, Caesarean. Conditions attached to the delivery and obstetric procedures such as cephalopelvic disproportion and obstructed labor. And the mother and pregnancy condition itself, such as large number of previous pregnancies and ectopic pregnancy (in anomalous location such as the fallopian tube). In order to reduce the risk of obstetric complications, it is recommended that the interval between births is another of at least two years.

The rupture during pregnancy is rare and can occur so little symptomatic, causing an inaccurate abdominal pain and vaginal bleeding, with worsening of an evolutionary way table. The most traditional form of uterine rupture occurs during labor, and the previous surgical trauma uterine the main risk factors, especially (s) caesarean section (s) prior (s).

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Rupture in childbirth

When occurs during labor, the clinical picture usually presents with sudden pain and well located in the abdomen, delivery stops progressing and the patient has repercussions of major bleeding caused by the rupture of the uterus, such as hypotension and worsening to shock hypovolemic, which is a rapid loss of circulating blood volume in the blood vessels with poor tissue perfusion.

Out of curiosity, there are cases in which organ failure is incomplete, when some of the layers of the uterus remains intact in these cases the clinical picture is milder and most of the time the diagnosis is made only after delivery.

Diagnosis

In classical paintings the diagnosis is made, most clinically with clinical and physical examination of the patient. In more difficult cases, ultrasound can help clarify the diagnosis. Important in these cases is the immediate conduct after the discovery of this complication. Being the emergency caesarean section a measure that can even attempt to extract the fetus still alive and later to the suture the uterus.

This complication is serious, rarely causes maternal death, but fetal death can reach up to 60% of cases. Therefore, we must guide the patient to the appropriate prenatal care, in which the risk factors are evaluated and explained to the mother. Just as it is important that labor signals to be recognized in this way the mother will seek a maternity service in a timely manner to carry out an assistance ideal labor, reducing the risk of this complication.

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