We present a case of uterine rupture presenting as significant urinary retention that occurred following a second trimester abortion induced with mifepristone and misoprostol. Uterine rupture was discovered unexpectedly on diagnostic laparoscopy. [ncbi.nlm.nih.gov]

(assisted) (buttocks) (complete) (frank) (spontaneous) 652.2 brow presentation 652.4 cephalopelvic disproportion (normally formed fetus) 653.4 cerebral hemorrhage 674.0 cervical dystocia 661.2 chin presentation 652.4 cicatrix coagulation defect 649.3 [icd9data.com]

• Severe Pain

  After the fifth pessary, she complained of severe pain. At the ultrasound examination, uterine cavity appeared empty and the dead fetus was dislocated in the abdomen. Emergency laparotomy was performed and uterine tear was repaired. [ncbi.nlm.nih.gov]

  Patients appear anxious and complain about severe pain and tenderness. Clinical diagnosis of a uterine rupture The diagnosis of a uterine rupture can usually be done clinically. [lecturio.com]

  Mother has severe pain — uterine rupture: $9M settlement At 37 weeks’ gestation, a woman went to the hospital with contractions and abdominal pain 2 weeks before her scheduled delivery. She had a previous cesarean delivery. [mdedge.com]

• Falling

  A 34-year-old multiparous woman presented at 22(+6) weeks' gestation with severe abdominal pain which preceded a mechanical fall down the stairs. On admission, fetal movements were felt and fetal heart rate was detected by Doppler ultrasound. [ncbi.nlm.nih.gov]

  Chest pain, pain between the scapulae, or pain on inspiration—Pain occurs because of the irritation of blood below the woman's diaphragm Hypovolemic shock caused by haemorrhage— Falling blood pressure, tachycardia, tachypnea, pallor, cool and clammy skin [en.wikipedia.org]

  Codes were used correctly in 81.3% of the nonrupture charts to record a condition that falls within the ICD-9-CM definitions. [cdc.gov]

  A rupture in an unscarred uterus has been attributed to trauma (as in an accident or a fall), weakness in the middle layer of the uterine wall (which functions to induce contractions), disorders of the collagen matrix, and abnormal architecture of the [abclawcenters.com]

• Disability

  Long-term outcomes of a mismanaged uterine rupture When uterine rupture causes birth asphyxia, this may lead to permanent brain damage and a variety of disabilities. [abclawcenters.com]

  Uterine rupture is a when the muscular wall of the uterus tears during pregnancy or childbirth. [3] Symptoms while classically including increased pain, vaginal bleeding, or a change in contractions are not always present. [1] [2] Disability or death [en.wikipedia.org]

  Other complications as a result of a uterine rupture can have lifelong consequences, including brain damage and learning disabilities. [teeslaw.com]

  […] fluids) Neonatal or fetal death typically caused by anoxic brain injury or hemorrhage Maternal death, typically because of excessive bleeding If the baby survives the uterine tear, they often experience developmental delays or suffer from congenital disabilities [rosenfeldinjurylawyers.com]

• Tachypnea

  Chest pain, pain between the scapulae, or pain on inspiration—Pain occurs because of the irritation of blood below the woman's diaphragm Hypovolemic shock caused by haemorrhage— Falling blood pressure, tachycardia, tachypnea, pallor, cool and clammy skin [en.wikipedia.org]

• Abdominal Pain

  Common presenting signs and symptoms include abdominal pain, fetal heart rate abnormalities, and evidence of hypovolemia. [ncbi.nlm.nih.gov]

• Severe Abdominal Pain

  A 33-year-old patient presented with severe abdominal pain in the 21st week of gestation at the department of abdominal surgery. A laparoscopy was performed to exclude appendicitis. [ncbi.nlm.nih.gov]

  A sudden pause in contractions takes place after rupture, along with an abnormal fetal heart rate (usually bradycardia ), severe abdominal pain, vaginal bleeding, and hemodynamic instability. [amboss.com]

• Acute Abdomen

  In addition, we recommend laparoscopy for the investigation of acute abdomen with unclear diagnosis in the first trimester of pregnancy. [ncbi.nlm.nih.gov]

• Tachycardia

  Fetal tachycardia was more frequent in cases with uterine rupture (OR 2.50 [CI: 1.0-6.26] P = 0.053). Significantly more cases showed more than 10 severe variable decelerations compared with controls (OR 22 [CI: 1.54-314.2] P = 0.022). [ncbi.nlm.nih.gov]

  Chest pain, pain between the scapulae, or pain on inspiration—Pain occurs because of the irritation of blood below the woman's diaphragm Hypovolemic shock caused by haemorrhage— Falling blood pressure, tachycardia, tachypnea, pallor, cool and clammy skin [en.wikipedia.org]

  Significant haemorrhage can produce signs of hypovolaemic shock ; such as tachycardia and hypotension. Fetal monitoring may reveal fetal distress or absent heart sounds. [teachmeobgyn.com]

  Maternal tachycardia, hypotension or shock. Movement away of the presenting part. [patient.info]

  Maternal tachycardia Mother’s heart rate increases to a high rate. Loss of station: The station of the baby refers to the location of the baby in the birth canal. [birthinjurysafety.org]

• Absent Fetal Heart Sounds

  The fall in blood pressure is often a late sign of haemorrhage Signs associated with fetal oxygenation, such as late deceleration, reduced variability, tachycardia, and bradycardia Absent fetal heart sounds with a large disruption of the placenta; absent [en.wikipedia.org]

  Her abdominal examination revealed 36 weeks sized uterus with maintained contour, absent fetal heart sound, no tenderness, and without superficial palpable fetal parts. [jpgmonline.com]

• Fear

  It was feared that the epidural anesthesia would mask abdominal pain that may present with a ruptured uterus and delay diagnosis. [ncbi.nlm.nih.gov]

  Virtually every homebirthing woman must deal with family fears or desires about VBAC, potential hospital transport and the politics surrounding midwifery in her area. [midwiferytoday.com]

• Cesarean Section

  OBJECTIVE: To determine the true incidence of complete uterine rupture and uterine dehiscence among women delivered by cesarean section after a previous cesarean section. [ncbi.nlm.nih.gov]

• Vaginal Bleeding

  Placenta praevia – typically causes a painless vaginal bleeding. Vasa praevia – characterised by a triad of ruptured membranes, painless vaginal bleeding, and fetal bradycardia. [teachmeobgyn.com]

  bleeding Hemodynamic instability (as a result of abdominal bleeding) Loss of fetal station Palpable fetal parts through the rupture References: [5] [7] [8] [4] [9] [3] Subtypes and variants Differential diagnoses See → Differential diagnosis of vaginal [amboss.com]

  Bleeding Vaginal bleeding is a classic finding of UR.. [medicaljoyworks.com]

  Uterine rupture classically presents with severe abdominal pain, loss of fetal station, vaginal bleeding, and shock. [ncbi.nlm.nih.gov]

• Uterine Hemorrhage

  Prompt maternal supportive and resuscitative measures should be undertaken to avoid catastrophic consequences like life-threatening uterine hemorrhage and maternal shock. Once the rupture uterus is diagnosed, prompt management is the essence. [ijcm.org.in]

Initial workup revealed placenta accreta and possible percreta (Figure 1 ) [4]. The patient was placed on IM corticosteroids in anticipation of preterm delivery. As soon as the patient was stable, she was discharged home. [cureus.com]

Surgical treatment could be the preferred approach for this situation. [ncbi.nlm.nih.gov]

[…] or makes a mistake during treatment. [rossfellercasey.com]

KEYWORDS: Guinea; fetal prognosis; maternal prognosis; maternity Donka; uterine rupture [Indexed for MEDLINE] Free full text [ncbi.nlm.nih.gov]

Treatment and prognosis Uterine rupture is most often an obstetric emergency (especially if associated with pregnancy). [radiopaedia.org]

Prognosis [ 4 ] 6.2% of uterine ruptures are associated with perinatal death. 14-33% of women with uterine rupture require an emergency hysterectomy. [patient.info]

Aims and objective: To investigate the incidence, etiology, diagnosis, treatment and outcome of uterine rupture. [jdrntruhs.org]

Obstetricians and gynecologists, family physicians After completing this CME activity, physicians should be better able to compare the etiology and presentation of uterine rupture in resource-poor countries as contrasted with the presentation of this [doi.org]

Etiology Uterine rupture is primarily caused by uterine distention. Theoretically, this can occur at any stage of pregnancy ; however, it usually takes place during active labor because of the massive force exerted during contractions. [amboss.com]

Etiology of Uterine Rupture Relative imbalance in uterine rupture Uterine ruptures are caused by an imbalance between the strain on the uterine wall and the stability of the uterus. [lecturio.com]

Rupture uterus: changing trends in etiology and management. J Postgrad Med. 1991 Jul;37(3):136-9. 9. Aboyeji AP, Ijaiya MD, Yahaya UR. Ruptured uterus: a study of 100 consecutive cases in Ilorin, Nigeria. [journals.ke-i.org]

Epidemiology Incidence : 1/4000 births References: [1] [2] Epidemiological data refers to the US, unless otherwise specified. Etiology Uterine rupture is primarily caused by uterine distention. [amboss.com]

Abstract A descriptive study was conducted to investigate the epidemiology and the outcome of uterine rupture at Hajjah Hospital, Yemen, during September 2014-August 2016. [ncbi.nlm.nih.gov]

Kathryn Fitzpatrick and colleagues from the National Perinatal Epidemiology Unit based at the University of Oxford in the UK found that from April 2009 to April 2010, 159 women experienced uterine rupture in the UK, of whom 139 had previously delivered [sciencedaily.com]

Epidemiology of Uterine Rupture Even nowadays, uterine ruptures are very frequent. This severe complication occurs in 1 of 1.500 deliveries. [lecturio.com]

Based on the pathophysiology of complete uterine wall separation, changes in uterine activity are expected. The primary objective is to identify tocogram characteristics associated with uterine rupture during trial of labor after cesarean section. [ncbi.nlm.nih.gov]

The pathophysiology of morbidly adherent placenta is characterized by abnormal adherence and invasion of the placenta to the superficial and deep layers of the uterine wall [1]. [cureus.com]

This is expected because uterine rupture is a traumatic event and haemorrhage is part of its pathophysiology. [njcponline.com]

A pathophysiological explanation of this may be the degree of myometrial fragility which is acquired with successive pregnancies [ 15 ]. In our study, it was observed that parity and maternal age were indeed risk factors. [omicsonline.org]

How Can Uterine Rupture Be Prevented? Uterine rupture can be significantly harmful for both mother and baby – even resulting in death. So, any preventative measures that can be taken, should be. [rossfellercasey.com]

Once again, preventing the scar helps to prevent the rupture. [midwiferytoday.com]

Can uterine rupture be prevented? The only way to prevent uterine rupture is to have a cesarean delivery. It can’t be fully prevented during vaginal birth. A uterine rupture shouldn’t stop you from choosing vaginal birth. [healthline.com]

Prevention of poor outcomes depends on thorough anticipation and preparation. The physicians and the delivery institution should be prepared to provide emergency surgical and neonatal care in the event of uterine rupture. [ncbi.nlm.nih.gov]

You may also be given antibiotics to prevent infection. [whattoexpect.com]