Uterine Rupture – What it is and why it happens
Uterine rupture is a tear in the wall of the uterus, most often at the site of a previous caeserean section (C-section). In a complete rupture the tear goes through all layers of the uterine wall.
The consequences of uterine rupture can be dire for mother and child. Fortunately, these ruptures are relatively rare for women who have never had a C-section, a previous rupture or other uterine surgery.
The vast majority of uterine ruptures occur during labour, but they can also happen during pregnancy.
Signs of uterine rupture
The first sign of a rupture is usually an abnormality in the baby’s heart rate. This is why a woman attempting a vaginal birth after a C-section needs continuous fetal monitoring. The mother may have symptoms such as abdominal pain, vaginal bleeding, a rapid pulse and other signs of shock. She may even experience pain in her chest caused by irritation to the diaphragm from internal bleeding.
Causes of uterine rupture
Ninety percent of uterine ruptures occur at the site of a scar from a previous C-section. Ruptures are most likely to occur during labour because a scar is more likely to give way under stressful conditions. For this reason women who have a previous C-section delivery are generally advised against attempting a vaginal delivery without the keen observation of a qualified obstetrician.
Other causes can be due to a placenta that has implanted too deeply in the uterine wall, an over-distended uterus (from too much amniotic fluid or when a woman is carrying twins or more babies), and from contractions that are too frequent and forceful whether spontaneous or from medication such as oxytocin or prostaglandins.
Also prolonged labour with a baby that is too big for the mother’s pelvis and trauma to the uterus from such incidents as a car accident or a difficult vaginal birth after a C-section can all precipitate a rupture. In addition, forceps delivery or a difficult manual removal of the placenta can also cause the uterus to rupture.
How to treat uterine rupture
An emergency C-section delivers the baby. If the damage to the mother’s uterus is extensive and the bleeding is uncontrollable, she may need a hysterectomy (complete removal of the uterus). Otherwise if the damage to the uterus is not extensive it may undergo repair.
The mother usually loses a lot of blood and may require blood transfusion. She will also be given some antibiotics to prevent infection.
If this happens to you, you will need to take it easy to recover from both your surgery and the effects of losing blood. You may feel weak and at first you should not try to get out of bed on your own. Ensure that you get a lot of rest, eat nutritious meals with plenty of iron, drink plenty of fluids. And keenly follow instructions given by your doctor.
Real life story on uterine rupture: She had a ruptured uterus
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END: PG 2/15