Uterine Rupture: Fatal Emergencies Continue to Occur Whys and Possibilities of Prevention
Journal Title: The Indian Practitioner - Year 2016, Vol 69, Issue 5
Abstract
Introduction: Uterine rupture is a fatal emergency, which leads to high maternal, perinatal morbidity, mortality continues to occur. Present article is with the objective of update and sharing. Present status: Uterine rupture could be complete or incomplete (inner layers torn but outer intact, or outer layer with part of myometrium torn but not extending into inner layer). Frequency in the developed countries was decreased because of availability, utilisation of quality care, but recent reports reveal increase, may be due to more interventions / more caesarean births. So there is renewed interest. Rupture could occur spontaneously during pregnancy in a weakened uterus of multiparity or previous caesarean section or other surgery or accident or intrauterine, manipulations. During labour it could be spontaneous, either because of obstruction due to contracted, deformed pelvis, malpresentations, multiple pregnancy, macrosomia, foetal anomalies, oxytocics, PCS, other surgery or perforation or trauma or previous uterine rupture or uterine anomaly. Diagnosis is delayed, unless possibility of rupture is kept in mind, because prior to circulatory collapse, signs, symptoms, may appear bizarre. Classic signs, sudden tearing pain, vaginal bleeding, cessation of contractions, regression of foetus are frequently absent. Non reassuring foetal heart rate may be indicative of imminent rupture. Thorough history /clinical examination are enough for diagnosis. Ultrasound shows abnormal foetal position / haemoperitoneum. Fatal exsanguination may supervene if broad ligament haematoma of incomplete rupture gives way relieving tamponading effect. Hypofibrinogenaemia may lead to complications. Therapy is general, depending on condition of patient, followed by laparotomy repair of rupture with or without tubectomy or hysterectomy depending on age, parity, patient’s condition, rupture site, skill of surgeon. Conclusion: It is essential to try prevention of rupture uterus, a catastrophic event by appropriate timely prenatal, intranatal evidence based care. If it occurs the mission has to be quality survival.
Authors and Affiliations
s Chhabra, P Borkar
Keywords
Related Articles
- EP ID EP569430
- DOI -
- Views 74
- Downloads 0
Fraxinus excelsior and Vitamin E Combination for NAFLD (FEVEN)
Objective: The combination of Vitamin E 400 IU soft gelatin capsule and Fraxinus excelsior 500 mg soft gelatin capsules (Ensules+) were evaluated for safety and efficacy as compared to Vitamin E 400 IU soft gelatin capsu...
Mucinous cystadenoma of the appendix: A Case Report
Mucocoele of the appendix is a rare cystic dilatation of the appendiceal lumen caused by mucinous secretions and consecutive retention of mucus. It can be caused by either non-neoplastic or primary epithelial neoplastic...
Delayed Peripheral Neuropathy due to Organophosphate Tri-Ortho-Cresyl Phosphate Poisoning
Introduction: 15 patients were admitted to Civil Hospital, Ahmedabad with complains of cramping pain and weakness in bilateral lower limbs. They were found to be suffering from subacute motor neuropathy. Material And Met...
Cervical Myelopathy – A life-threatening complication of Rheumatoid Arthritis
A middle-aged female with erosive Rheumatoid arthritis (RA) of ten years duration, presented in the emergency services with chronic neck pain, acute quadriparesis and respiratory distress. Cervical spine imaging showed a...
High Altitude Medicine on Himalayan Treks and Expeditions
The term mountaineering includes the sport of mountain climbing, as well as ski mountaineering. It is one of the finest outdoor opportunities which are available for a person who loves high places or altitudes. Mountaine...