| Uterine Rupture |
| What is uterine rupture? |
| A true uterine rupture is when there is a complete hole or tear in the uterine wall leading directly into the peritoneal cavities. A uterine rupture is a potentially life-threatening condition for both mom and baby. |
| There are several causes of uterine rupture. Many are associated with VBAC (Vaginal Birth after Cesarean) or TOL (Trial of Labour) My uterine rupture happened on an unscarred uterus, sometimes called a SPONTANEOUS rupture. Uterine ruptures can also happen due to trauma, such as a car accident. In many cases, uterine ruptures happen during labour, often during medical inductions (drugs given to start contractions) or augmentations (drugs given to strengthen contractions). A common drug used to induce or augment is oxytocin (Brand name Pitocin). Another drug that has been linked to uterine rupture is Cytotec, which is a drug used to "ripen" the cervix as a way to induce labor. Uterine ruptures can be mild to catastrophic. Sometimes uterine dehisence or windows are called ruptures. A dehisence or window is a thinning of the uterus and may or may not be cause for alarm. A true rupture happens when there is an actual opening in the uterus and is always an emergency. A cesarean section is needed for a uterine rupture that happens prior to delivery of the baby. If you suffer a uterine rupture, the outcomes vary from no lasting effects to death of mom and/or baby. Uterine ruptures can happen with no signs or symptoms. But some signs that you may be having a uterine rupture are: * Fetal Bradycardia * Severe pain not associated with contractions (sometimes described as a ripping or tearing feeling) * Tachycardia * Cessation of labor * Sharp drop in Fetal Heart Rate * Recession of fetal head (or presenting part) * Bulging abdomen * Excessive vaginal bleeding Some things that may increase your risk of uterine rupture are: * Induction/cervical ripening * Cesarian Section * Grand Multiparity * Older maternal age * D&C * Myomectomy * Macrosomic baby * Poor Nutriution * A fever post c-section |
| WHAT SHOULD I DO TO PREVENT UTERINE RUPTURE? |
| There are two schools of thought on this. Some believe that in order to reduce your chances of having an uterine rupture, you should have a home birth or at least one that has no medical intervention. Intervention meaning everything from CFM to vaginal exams; to use of Oxytocin; to not being allowed to labor/push in any position that feels "right" to the mother. The other side says that all women who have any kind of uterine scar or defect (such as a uterine horn) should give birth only in a hospital with CFM and an OR staff ready to do a c-section within 17 minutes. I think both sides would agree to the following: * Educate yourself and your careprovider on the signs of uterine rupture (although, again, it's possible to rupture without any signs.) * No induction or cervical ripening drugs of any kind. * Have a strong support person with you. * Trust your instincts. |