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Child birth at Risk: Uterine Rupture

  • Occurs when uterus undergoes more strain than it is capable of sustaining.
  • Precipitating factors include the following:

a.    Positive vertical scar from previous CS birth, hysterectomy.
b.    Prolonged labor.
c.    Faulty presentation.
d.    Multiple gestations.
e.    Obstructed labor.
f.    Unwise use of oxytocin.

  • It is often suggested by Brandt’s pathologic retraction ring and strong uterine contractions without cervical dilation.
  • Schedule a CS immediately to prevent rupture.
  • Assessment:    -    positive sudden, severe pain during strong contractions.

-    Woman may report a tearing sensation.
-    Uterine contractions stop after rupture.
-    Signs and symptoms of shock begin as a result of hemorrhage from torn uterus.
-    Fetal heart sounds fail.

  • Management:  emergency situation

-    Fluid displacement immediately to counteract shock.
-    Oxytocin via IV may be administered as ordered to contract uterus and minimize bleeding.
-    Woman may be advised against another pregnancy unless rupture happened at lower segment.
-    Provide emotional support.

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