Rupture of the Uterus
Definition: When there is a tear or cut in the uterus. It is oneof the obstetric emergencies.
· Weak caesarian section scar
· Trauma during operative manipulation per vagina
· The unwise use of oxytocic drug
· Obstructed labour.
- Wound healed by secondary or more of stage - If another pregnancy occurs with in six months
- Over distension as in subsequent twin or ployhydraminos
Occurrence- During 1st stage of labour or the last four weeks of pregnancy.
Sign and symptoms
· Constant abdominal pain accompanied by vomiting even when the pulse below 100.
· Vaginal bleeding
· Labour should be conducted in hospital
· Reduced abdominal palpation to a minimum and perform with great gentleness.
Observation: - Record and Report
· Increased tenderness over the scar
· Constant pain in the abdomen
· Slight or no advance, with good contractions during 1st stage
· Insufficient advance during 2nd stage
· Arise pulse rate
· Vaginal bleeding
Cause- When labour is obstructed it causes excessive thinning of the lower uterine segment during labour.It is more common during 2nd stage of labor
Signs and Symptoms
i. Rising pulse rate
ii. Tonic contraction and Bandl’s ring
iii. Tenderness of the lower uterine segment
iv. Vaginal bleeding
In case of actual rupture
· Mother feel separate mass & some thing has given way and contraction cease
· Cessation of FHB
· Abdominal or shoulder pain
· Lay the patient flat, put IV drip
· Pethidine 50mg for pain reliving
· Treat for shock
· Transfer to the hospital quickly
· Lie flat, prepare blood for transfusion
· Prepare for operation
- Operative procedure
e.g internal version, craniotomy
· Extraction of the after coming head of the hydrocephalus baby:
e.g Cervical tear
Cause - Using intravenously or intramuscularly to induce labour
· Incomplete rupture the myometrium and endometriumare ruptured and the perimetrium remains intact.
· Complete rupture all uterine layers are torn.
i. Lie patient flat
ii. Take blood for grouping and cross matching
iii. Put up Intravenous drip & give pethidine 50 mg
iv. Transfer to the hospital
· Lie patient flat
· Blood group and cross match
· Put Intravenous drip
· Get patient to sign consent form
· Give pre medication
· Carry out doctor’s order
· Usually still born
· Incase of incomplete rupture and if it happens in the hospital it is possible to have a live baby.
· Repair of the uterus if the it torn anteriorly
Postoperative care is the same with other postoperative cases.