Uterine rupture is tearing of the wall of theuterus, most often at the site of a previous c-section incision. When a complete rupture occurs, the tear goes through all layers of the uterine wall and the consequences can be dire for mother and baby. Uterine rupture is rare. It can occur during late pregnancy or active labor.
A uterine scar rupture cannot be predicted before it happens, only diagnosed as it actually occurs. There are studies that suggest measuring the thickness of the scar by ultrasound, or following closely the pattern of contractions in labour may indicate if a rupture is likely to occur. The first sign of a rupture is usually an abnormality in the baby’s heart rate. The symptoms which may be found in mother is as follows:-
- Excessive vaginal bleeding
- A heavy pain between contractions or pain at scar site
- Unusual abdominal pain or tenderness
- The uterus loses muscle tone (uterine atony)
- A rapid pulse, and other signs of shock
At the time of labor, baby is moved through the mothers birth canal which causes pressure and may lead to tearing of the uterus. Tear usually happens at the site of a pervious caesarian section scar. During uterine rupture the uterus’s contents and even the baby may fall into the mother’s abdomen.
Causes of uterine rupture include
- Uterine overdistention (multiple gestation, polyhydramnios, fetal anomalies)
- External or internal fetal version
- Latrogenic perforation
- Excessive use of uterotonics
- Failure to recognize labor dystocia with excessive uterine contractions against a lower uterine restriction ring
How is it treated?
An urgent surgical delivery is done as an initial management. If the damage to the woman’s uterus is extensive and the bleeding can’t be controlled, surgeons may need to remove a woman’s uterus to control her bleeding. After this procedure, a woman can no longer become pregnant. Women with excessive blood loss may need to receive blood transfusions. And she’s usually given IV antibiotics to prevent infection. Doctors will improve the baby’s chances of survival by administering critical care, such as oxygen.
Once you’re home, make sure you get lots of rest, eat nutritious meals and drink plenty of fluids, take iron, and follow your caregiver’s instructions to the letter.
Risks of uterine rupture can be reduced if:
- Labour begins on its own (no induction of labour) and continues without augmentation.
- Your due date is at least 18 months after your previous c-section.
- Previous c-section incision was low transverse.
- Successful VBAC done before
- A previous c-section is done before
According to studies expert says that women who had gone through previous c-section and low transverse scar, chances of uterine rupture is very low.
Make the best decision for you and your baby with the support of your care provider. Always make sure that doctor is also aware of your medical history that is you had a caesarian section in your previous delivery or gone through some surgeries in uterus.