Uterine rupture: what it is, symptoms, causes and treatment

Uterine rupture is the disruption of the muscles of the uterus during the last trimester of pregnancy or at the time of birth, which can result in excessive bleeding and severe abdominal pain, being a serious obstetric complication.

Uterine rupture, also called uterine rupture, is more common in women who have uterine scars, whether due to previous births or gynecological surgeries, and it is important in all cases that the pregnancy is monitored by an obstetrician.

Treatment of uterine rupture must be carried out immediately, generally with a cesarean section, so that complications that can put the life of the woman and the baby at risk can be prevented.

Symptoms of uterine rupture

The main symptoms of uterine rupture are:

• Severe abdominal pain with sudden onset;
• Excessive, bright red vaginal bleeding;
• Sudden pain between contractions;
• Loss of muscle tone in the uterus, making contractions slower or weaker;
• Stopping of contractions after severe abdominal pain;
• Pain in the anterior uterine scar;
• Heart palpitation;
• Drop in blood pressure;
• Dizziness;
• Nausea or vomiting;
• Anxiety.

In addition, symptoms of hypovolemic shock may appear, which is a situation that occurs as a result of the loss of a large amount of blood, and which leads to the appearance of some symptoms, such as pale and cold skin, mental confusion and purple fingers and lips. Learn how to identify hypovolemic shock.

Uterine rupture can also cause changes in the baby and lead to fetal distress, with symptoms such as a rapid decrease or change in the fetal heartbeat.

Symptoms of uterine rupture can appear during the last trimester of pregnancy or at the time of birth, and it is important to get immediate medical help or seek the nearest emergency room if symptoms appear so that treatment can be carried out as quickly as possible.

How to confirm the diagnosis

The diagnosis of uterine rupture is made by the obstetrician through analysis of symptoms, gynecological evaluation and blood tests, such as blood count, hematocrit and blood coagulation tests.

In addition, the doctor may order an ultrasound to identify the place in the uterus that ruptured, in addition to monitoring the fetal heartbeat.

Possible causes

Uterine rupture happens more frequently in women who have uterine scars, which may be due to previous vaginal births or cesarean sections, for example. Other situations that increase the risk of rupture are:

• Multiple gestation;
• Performing uterine curettage;
• Changes in the uterus, such as myoma or adenomyoma;
• Prolonged labor;
• Consumption of drugs of abuse, such as cocaine;
• Error during execution or improper performance of the Kristeller maneuver;
• Wounds in the abdominal region;
• Administration of an inadequate amount of oxytocin or another uterotonic during the birth process;
• Error during the labor induction process;
• Endometriosis;
• Gestational diabetes with macrossomia;
• Polyhydramnios, which is an excess of amniotic fluid;
• Placental abruption;
• Gestational trophoblastic disease.

Furthermore, uterine rupture can also occur as a result of placenta accreta, which is a situation in which the placenta is incorrectly fixed, so that it does not come out as easily during childbirth. Understand what placenta accreta is and how to identify it.

Although it is less common, uterine rupture can also occur in situations unrelated to pregnancy, such as trauma, infection or uterine cancer, for example.

How the treatment is carried out

Treatment for uterine rupture consists of performing a cesarean section immediately and adopting measures to reduce bleeding, preventing complications for the mother and baby. In some cases, to stop the bleeding, the doctor may recommend a hysterectomy, which is a surgical procedure in which the uterus is removed. Understand what a hysterectomy is and what to do.

Furthermore, the possibility of performing blood transfusions can also be considered to replace lost blood and thus promote symptom relief and women’s improvement.

In the case of a baby, as uterine rupture can cause a decrease in heart rate, it is common for the baby in these situations to be sent to the neonatal ICU to be monitored and monitored, in order to prevent complications.

Possible complications

Uterine rupture can cause complications for women, such as the impossibility of another pregnancy due to surgical removal of the uterus.

Furthermore, uterine rupture can also cause complications for the baby, such as fetal distress, acidosis, decreased Apgar score, decreased or lack of oxygen for the baby.

Therefore, uterine rupture must be treated as soon as possible, in order to prevent complications that could put the life of the woman and the baby at risk.