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    UTERINE RUPTURE Rupture of The Uterus During Labor

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    ANNE
    Uterine rupture during labor is a medical emergency that occurs most often in women with a previous cesarean scar. It can be complete, tearing through the uterus, or incomplete. Complete rupture causes contractions to immediately stop and bleeding into the abdominal cavity, potentially leading to shock. Incomplete rupture causes localized pain but fetal and maternal distress will be revealed over time. Emergency surgery is needed to control bleeding and deliver the baby to save both lives, but the fetus' viability depends on the extent and time of rupture. Most women are advised against future pregnancies after a rupture due to the damage and risks.

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    UTERINE RUPTURE Rupture of The Uterus During Labor

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    ANNE
    55 views3 pages
    Uterine rupture during labor is a medical emergency that occurs most often in women with a previous cesarean scar. It can be complete, tearing through the uterus, or incomplete. Complete rupture causes contractions to immediately stop and bleeding into the abdominal cavity, potentially leading to shock. Incomplete rupture causes localized pain but fetal and maternal distress will be revealed over time. Emergency surgery is needed to control bleeding and deliver the baby to save both lives, but the fetus' viability depends on the extent and time of rupture. Most women are advised against future pregnancies after a rupture due to the damage and risks.

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    Rupture of the uterus during labor

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    UTERINE RUPTURE Rupture of the uterus during labor

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    Uterine rupture during labor is a medical emergency that occurs most often in women with a previous cesarean scar. It can be complete, tearing through the uterus, or incomplete. Complete rupture causes contractions to immediately stop and bleeding into the abdominal cavity, potentially leading to shock. Incomplete rupture causes localized pain but fetal and maternal distress will be revealed over time. Emergency surgery is needed to control bleeding and deliver the baby to save both lives, but the fetus' viability depends on the extent and time of rupture. Most women are advised against future pregnancies after a rupture due to the damage and risks.

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    Download as docx, pdf, or txt
    55 views3 pages

    UTERINE RUPTURE Rupture of The Uterus During Labor

    Uploaded by

    ANNE
    Uterine rupture during labor is a medical emergency that occurs most often in women with a previous cesarean scar. It can be complete, tearing through the uterus, or incomplete. Complete rupture causes contractions to immediately stop and bleeding into the abdominal cavity, potentially leading to shock. Incomplete rupture causes localized pain but fetal and maternal distress will be revealed over time. Emergency surgery is needed to control bleeding and deliver the baby to save both lives, but the fetus' viability depends on the extent and time of rupture. Most women are advised against future pregnancies after a rupture due to the damage and risks.

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    UTERINE RUPTURE Rupture of the uterus during labor, although rare, is always a

    possibility. It occurs most often in women who have a previous cesarean scar

    (Vachon-Marceau, Demers, Goyet, et al., 2016). Contributing factors may include

    prolonged labor, abnormal presentation, multiple gestation, unwise use of

    oxytocin, obstructed labor, and traumatic maneuvers of forceps or traction. When

    uterine rupture occurs, fetal death will follow unless immediate cesarean birth

    can be accomplished.

    If a uterus should rupture, the woman experiences a sudden, severe pain during a

    strong labor contraction, which she may report as a “tearing” sensation. Rupture

    can be complete, going through the endometrium, myometrium, and peritoneum

    layers, or incomplete, leaving the peritoneum intact. With a complete rupture,

    uterine contractions will immediately stop. Two distinct swellings will be visible

    on the woman’s abdomen: the retracted uterus and the extrauterine fetus.

    Hemorrhage from the torn uterine arteries floods into the abdominal cavity and

    possibly into the vagina. Signs of hypotensive shock begin, including a rapid, weak

    pulse; falling blood pressure; cold and clammy skin; and dilation of the nostrils

    from air starvation. Fetal heart sounds fade and then are absent
    If the rupture is incomplete, the signs of rupture are less evident. With an

    incomplete rupture, a woman may experience only a localized tenderness and a

    persistent aching pain over the area of the lower uterine segment. However, fetal

    heart sounds, a lack of contractions, and the changes in the woman’s vital signs

    will gradually reveal fetal and maternal distress. The rupture can be confirmed by

    ultrasound

    because the uterus at the end of pregnancy is such a vascular organ, uterine

    rupture is an immediate emergency, comparable to splenic or hepatic rupture.

    Administer emergency fluid replacement therapy as prescribed. Anticipate the

    use of IV oxytocin to attempt to contract the uterus and minimize bleeding.

    Prepare the woman for a possible laparotomy as an emergency measure to

    control bleeding and birth the fetus. The viability of the fetus depends on the

    extent of the rupture and the time elapsed between rupture and abdominal

    extraction. A woman’s prognosis depends on the extent of the rupture and the

    blood loss.

    Most women are advised not to conceive again after a rupture of the uterus,

    unless the rupture occurred in the inactive lower segment. At the time of the

    rupture, the primary care provider, with consent, may perform a cesarean
    hysterectomy (i.e., removal of the damaged uterus) or tubal ligation, both of

    which will result in loss of childbearing ability. A woman may have difficulty giving

    her consent for a hysterectomy because it is unknown whether her present baby

    will live. If blood loss was acute, she may be nonresponsive because of decreased

    cerebral perfusion from hypotension. If this has happened, the woman’s support

    person must be the one who gives this consent, relying on the information

    provided by the primary care provider as to whether a functioning uterus can be

    saved (Choubey & Werner, 2015). Be prepared to offer information to the support

    person and to inform him or her about fetal outcome, the extent of the surgery,

    and the woman’s safety as soon as possible. Initially, a woman and her support

    person will probably be thankful her life was saved. However, they may become

    almost immediately angry the rupture occurred, especially if the fetus died and

    the woman will no longer be able to have children. Allow them time to express

    these emotions without feeling threatened. They may want to plan a funeral

    because, oftentimes, the baby is full term. Utilize clergy or counselors as needed

    to help the couple begin the coping process. They are not only grieving for the

    loss of a child but also the cost of unexpected surgery and perhaps loss of fertility.

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