Ruptured UTERUS

A real life account as witnessed by a maternity nurse

Her blood pressure was low and her skin pale because of losing a lot of blood. The baby was getting distressed because its oxygen supply was interrupted. It was an extremely dangerous situation for both mother and child. Alice (real name withheld) was rushed to the hospital bleeding profusely; the baby had to be delivered urgently through a caesarean section.

A woman who identified herself as a neighbour brought her to the hospital at around six in the evening. Alice had no medical records from her clinic when she was brought to the hospital. Her amniotic sac (her waters) had broken early in the morning. And the risk of her transmitting infections was high, so we gave her prophylaxis (preventative treatment).

The baby was too big for Alice’s pelvis

I asked her a few questions while examining her fetal heart rate. I found out that the woman who had brought her to hospital was actually not a neighbour as she had claimed. She was a nurse working at a local clinic where delivery of the baby had failed. The medical personnel at the clinic had not realized that Alice had an obstruction — the baby was too big for Alice’s pelvis. They had induced Alice with synthetic oxytocin (a hormone that stimulates contractions and hastens delivery) but after noticing that Alice had stayed for almost ten hours in labour with no signs of delivery they decided to transfer her to the hospital where I work as a maternity nurse.

Upon examination by the obstetrician, Alice’s uterus was found to have ruptured due to forceful contractions caused by induction of labour without the baby being expelled. As Alice had lost a lot of blood she had to undergo a blood transfusion to reduce associated risks.

The people who were running the clinic were quacks.

This was her first pregnancy; she had opted to deliver at a nearby clinic in her estate, as most of her friends and neighbours also delivered there. What she did not know is that the people who were running the clinic were quacks. They did not have the facilities or know-how to detect problems that could arise during delivery.

Alice could not deliver normally, even though she had dilated fully, due to the obstruction. After her condition was assessed, she was rushed to theatre where doctors tried to save the baby who was suspected to be already severely distressed. It was while in theatre that the doctors noticed that her uterus had badly ruptured. Uterine rupture is a tear on the wall of the uterus that often happens at the site of a previous caesarean section. The uterus can also tear as a result of prolonged labour with a baby that is too big for the mother’s pelvis, or from contractions that are too frequent or forceful, whether spontaneous or from medication such as oxytocin or prostaglandins (used to induce labour).

She would never conceive again

The baby girl was lucky to have survived; and was rushed to the newborn unit to be assessed by a paediatrician. This was to rule out any transmitted infections during her mother’s long labour. Sadly for Alice she lost her uterus as it had badly ruptured and could not be repaired. This meant she would never conceive again. It was sad to see a young lady like her losing her uterus due to carelessness by quacks. After four days of counselling and making her understand that she was lucky to be alive, she was discharged.

END: PG 2/14

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