(I) Uterine dehisence-separation of a preexisting scar without the disruption of parietal peritoneum.
(II)uterine rupture-full thickness disruption of uterine wall.
(I)previous caesarean section(Classical &Lower segment)
(II)Previous uterine surgery-myomectomy
(III)Grand multi parity
Uterine dehisence could be asymptomatic
(I)continuous lower abdominal pain
(III)receding presenting part in labour
(IV)loss of uterine contractility during labour
(V) Haematuria/Bleeding per vaginum
(VI)Maternal tachycardia & hypo tension are late signs
Stair case sign-stepwise gradual decrease in contraction amplitude has been reported in uterine rupture.
This is an Obstetrics emergency
resuscitation & surgery should go hand in hand.
call for Senior help(Obstetrician & Anaesthetist)
Arrange Cross matching of Blood(6-10 units)
Allocate one person to scribe the events
Keep the family informed during the procedure
Debrief at the end of procedure
If uterine rupture occurs prior to delivery emergency caesarean section should be done.
The following options can be selected according type of tear,state of the patient and ongoing blood loss.
(III)Internal artery ligation
Powerpoint on uterine rupture
(II)Successful management of gravid uterine rupture.Taiwan J Obstet Gynecol. 2009 Sep;48(3):319-20.Authors: Fu PT Chen CH Wu GJ Yu MH.PMID: 19797032 [PubMed - indexed for MEDLINE]
(III)Spontaneous uterine rupture-Case report and review