Prevention of uterine rupture
Release time : 05/09/2025 09:30:02
Are you aware of the preventive methods for uterine rupture? How much does this situation affect the process of childbirth? Do you know how to respond in such cases? Pregnant women, do not just focus on joy but also remember to prevent troublesome situations! Let's learn about them today! Uterine rupture is a common condition among pregnant women and often occurs during labor. Moreover, uterine rupture can endanger a pregnant woman's life, so it is important for pregnant women to timely prevent uterine rupture.
Below, let me introduce to everyone the prevention methods of uterine rupture.
Prevention of uterine rupture: Uterine rupture is a serious threat to maternal and fetal life, and the vast majority of uterine ruptures can be avoided. Therefore, prevention work is extremely important.
Strengthen the promotion and implementation of family planning, reducing the number of multiple pregnancies; shift the concept of childbirth towards natural childbirth, reducing the rate of cesarean delivery; strengthen prenatal examinations, rectifying fetal position, and for those who are estimated to have difficulties during childbirth, those with a history of difficult labor, or those with a history of cesarean section, it is advisable to be admitted for delivery early, closely monitor the progress of labor, and decide on the mode of delivery based on obstetric indications and the previous surgical experience.
Strict adherence to the indications, administration, and dosage of oxytocin is required; at the same time, a designated person should be on duty. For expectant mothers with a history of uterine scars or congenital anomalies, labor should be closely monitored, and the indications for cesarean section should be liberalized.
Close observation of the labor process is particularly crucial for expectant mothers with high cephalic presentation and abnormal fetal position, as well as those undergoing trial labor. It should be avoided to employ traumatic methods such as mid-high forceps delivery, attempting delivery before the cervix has fully dilated, neglecting shoulder presenting in vertex rotation, or forcibly extracting the placenta when it is embedded.
In summary, the above content discusses the prevention methods of uterine rupture, which can help pregnant women avoid uterine rupture. Pregnant women should maintain good moods, exercise appropriately to enhance their immunity.
Uterine rupture refers to the tearing of the uterine body or lower segment during childbirth or pregnancy, which is a severe complication in obstetrics and threatens the life of both mothers and newborns.
The primary causes of death were bleeding, infection, and shock.
With the improvement of obstetrics quality and the establishment and gradual improvement of urban and rural maternal and child health care networks, the incidence rate has dropped significantly.
It is rarely seen in urban hospitals, but it occurs from time to time in rural and remote areas.
There are two types of uterine rupture: (1) Complete uterine rupture: the entire uterine wall is torn, and part or all of the amniotic fluid, placenta, and fetus are expelled into the abdominal cavity.
Upon rupture, the patient suddenly experiences a tearing pain in the lower abdomen, followed by a cessation of contractions and a sudden relief of abdominal pain.
Soon, as the amniotic fluid, fetus, and blood entered the abdominal cavity, persistent total abdominal pain occurred. The mother developed shock symptoms and signs such as pale face, cold sweat, superficial breathing, thin pulses, and dropped blood pressure. Blood may flow out of the vagina, and the amount can be more or less.
When the presenting part of the fetus recedes, the dilated cervix retracts, and when the anterior wall of the uterus ruptures, the laceration may extend forward to rupture the bladder.
Abdominal examination reveals tenderness and rebound tenderness throughout the abdomen, palpable fetal limbs on the abdominal wall, absent fetal heart sounds, and unclear uterine outline. Sometimes, a smaller uterus can be palpated on one side of the fetus. If significant intra-abdominal hemorrhage occurs, movable dullness can be elicited by percussion.
Vaginal examination may reveal an ascending fetal presenting part and a contracted cervix, with sometimes a ruptured tear within the uterine cavity.
(2) Partial rupture: The myometrium is partially or completely split, while the serosa remains intact. The intrauterine cavity remains unconnected to the peritoneal cavity, and the fetus is still retained within the uterus.
If the tear is in the lower section of the uterine sidewall, a hematoma can form between the two lobes of the broad ligament. If the uterine artery is torn, severe extraperitoneal bleeding and shock can be caused.
Abdominal examination, the uterus still maintained its original appearance, with obvious tenderness after rupture, and a gradually increasing hematoma could be touched on one side of the abdomen.
Broad ligament hematoma can also extend upward to become a retroperitoneal hematoma.
If bleeding continues, the hematoma can penetrate the serosa layer and form a complete rupture of the uterus.
Clinical symptoms of uterine rupture Uterine rupture can occur in the third trimester before labor, but most of them occur when labor is difficult during labor, which is characterized by prolonged labor, the fetal head or presentation cannot enter the pelvis or is blocked at or above the level of the ischial spine.
Uterine rupture can be divided into two stages: pre-rupture and uterine rupture.
1. In the process of labor, when the fetal presenting part is blocked, strong contractions cause the lower segment of the uterus to gradually thin and the fundus to thicken and shorten. This results in a distinct ring-like depression between them, which gradually ascends to the level of the navel or above it, known as the pathological reduction ring.
At this time, the lower segment is bulging, with significant tenderness. The uterine ligaments are extremely tense, and a palpable and tender mass can be clearly felt.
The parturient complained of severe abdominal pain, restlessness and irritability, and called out. The pulse and respiration were quickened.
Due to the compression of the fetal presenting part against the bladder, congestion occurs, leading to difficulty in urinating and the formation of hematuria.
Due to excessive uterine contractions, fetal blood supply is obstructed, fetal heart rate changes or becomes inaudible.
If this condition is not relieved immediately, the uterus will rapidly rupture at the site of the pathologic retroflexion ring and below.
2. Based on the extent of uterine rupture, it can be classified into complete uterine rupture and incomplete uterine rupture.
(1) Complete uterine rupture: This refers to a situation where the uterine wall is completely torn, allowing communication between the uterus and the abdominal cavity.
At the moment of complete uterine rupture, the patient often experiences severe tearing abdominal pain. Subsequently, the contractions of the uterus disappear, and the pain is alleviated. However, as blood, amniotic fluid, and fetus enter the peritoneal cavity, the patient quickly feels full-body pain. The pulse becomes faster and weaker, respiration becomes rapid, and blood pressure drops.
Upon examination, there is tenderness and rebound tenderness throughout the abdomen. A palpable fetus can be clearly felt in the lower abdominal wall. The uterus has shrunk to the side of the fetus, and the fetal heartbeat has ceased. There may be blood flowing from the vagina, varying in quantity and amount.
The presenting part of the fetus, if it is not already descended or retracted (the fetus has entered the abdominal cavity), and the dilated cervix may contract.
When the uterine anterior wall ruptures, the laceration may extend anteriorly to rupture the bladder.
If a uterine rupture has been diagnosed, there is no need to examine the uterine rupture via vagina.
If the uterine rupture is caused by the injection of oxytocin, the patient feels strong contraction of the uterus after the injection, sudden severe pain, and then suddenly disappears. The abdominal examination as above.
Uterine scar rupture can occur during pregnancy, but more often during labor.
At the beginning, there was slight abdominal pain and tenderness at the scar site of the uterine incision. At this time, the uterine scar may have ruptured, but the membranes were not broken and the fetal heart rate was good.
If cesarean section is not performed immediately, the fetus may enter the abdominal cavity through the rupture, producing symptoms and signs similar to the above-mentioned uterine rupture.
(2) Incomplete uterine rupture: refers to the complete or partial rupture of the myometrium, the serosa layer has not yet been penetrated, the uterine cavity and the abdominal cavity are not connected, and the fetus and its appendages are still in the uterine cavity.
Abdominal examination shows tenderness at the incomplete rupture of the uterus; if the rupture occurs between the two lobes of the broad ligament on the lateral wall of the uterus, a hematoma within the broad ligament may form. At this time, a gradually increasing and tender mass may be touched on one side of the uterine body.
Fetal heart sounds are often irregular.
The treatment for uterine rupture requires immediate and effective measures to inhibit uterine contractions. This can be achieved through administering anesthesia with ether or muscle injections of dexmedetomidine, a dose of 100mg, among other methods. These interventions are aimed at slowing down the progression of the uterine rupture.
It is advisable to perform a cesarean section as soon as possible. During the procedure, attention should be paid to check for any signs of uterine rupture.
In cases where the uterus is ruptured and the fetus has not been delivered, even if the fetus is dead, it is inadvisable to attempt delivery of the fetus through the vagina. This would cause the rupture to widen, increase bleeding, and promote the spread of infection. It is imperative to rapidly perform a cesarean section to remove the dead fetus. The decision should be based on the patient's condition, the location and extent of the uterine rupture, the degree of infection, and whether the patient has already had children. In cases where the uterine rupture is relatively easy to suture, infection is not severe, and the patient's condition is poor, repair and suturing of the rupture can be considered. If the patient has children, tubal ligation should be performed; if not, their reproductive function should be preserved.
Otherwise, total or subtotal hysterectomy may be performed.
If the lower segment of the uterus is ruptured, attention should be paid to the bladder, ureter, cervix and vagina. If there is any damage, it should be repaired in time.
Uterine rupture is often accompanied by severe bleeding and infection. Blood transfusions, infusion, sodium lactate should be given before surgery, active anti-shock treatment should be given, and a large dose of broad-spectrum antibiotics should be used to control infection during and after surgery.
Precautions for Treating Uterine Rupture: Uterine rupture, which occurs at different levels of the body under the uterus during pregnancy or childbirth, affects many women's normal fertility. In severe cases, it can endanger the life safety of women.
Therefore, timely management of uterine rupture is essential.
Uterine rupture is one of the serious obstetric complications. The following points should be noted when handling: 1. ** Seek medical attention immediately **: If you suspect the possibility of uterine rupture, you should immediately contact a medical institution or call the emergency number. 2. ** Keep calm **: Try to remain calm and avoid excessive stress while waiting for medical assistance. 3. ** Avoid moving **: Try to avoid moving before the doctor clearly tells you that you can move to avoid exacerbating the injury. 4. ** Record symptoms **: Record the symptoms in detail, such as the nature, location, intensity, etc. of the pain. This information is very important for the doctor's diagnosis. 5. ** Don't take your own medicine **: Don't use painkillers or other drugs at will without your doctor's guidance, as some drugs may affect your doctor's judgment. 6. ** Follow your doctor's advice **: Follow your doctor's instructions, including whether surgery is needed, when it is needed, and how to cooperate with treatment. 7. ** Post-operative care **: After surgery, care should be strictly followed by doctor's advice, including rest, diet, activity restrictions, etc., to promote wound healing. 8. ** Regular review **: Conduct regular review according to the doctor's recommendation to detect and deal with possible complications in a timely manner. 9. ** Psychological support **: Faced with serious conditions such as uterine rupture, patients may feel fear and anxiety. Seeking psychological support and communicating with family, friends or professionals can help relieve psychological stress. 10. ** Preventive measures **: Understanding the causes of uterine rupture and prevention methods, such as pregnancy check-ups, reasonable diet, appropriate exercise, etc., can help reduce the risk of disease. Uterine rupture is a serious medical emergency that requires timely and professional treatment. I hope the above information will be helpful to you.
What should I pay attention to when dealing with uterine rupture? The main matters to pay attention to in the treatment of uterine rupture include: 1. Pay attention to the correct handling of scar uterine pregnancy. Experts pointed out that the treatment of uterine rupture should pay attention to the correct handling of scar uterine pregnancy.
For the scar uterus, a certain interval is needed after the previous operation.
2. Pay attention to strict contraception, avoid miscarriage, and pay special attention to the management of uterine rupture. The management of uterine rupture also requires strict contraception, adopting effective contraceptive measures to prevent artificial abortions.
At the same time, it is also important to enhance the monitoring of pregnancy.
3. Note that the most common treatment method for surgical treatment of uterine rupture is surgical treatment. When performing surgical treatment, pay attention to whether female friends have fertility requirements. If they have children and do not have fertility requirements, they can consider performing hysterectomy or bilateral fallopian tube ligation.
4. Attention should be paid to the management of shock and other issues encountered during surgery, including the treatment for uterine rupture. Special attention should also be given to managing symptoms such as shock, infection, anemia, etc. Close monitoring of changes in blood pressure, central venous pressure, blood gas analysis, and coagulation function and renal function is required. Oxygen administration, fluid and blood transfusion, replenishment of blood volume, effective antibiotics selection, and supplementation with various vitamins and iron supplements are necessary to enhance resistance.
The medical content discussed in this text is for reference only.
In case of discomfort, it is advised to seek medical attention immediately. The diagnosis and treatment should be based on the medical consultations conducted in person.