Silent
uterine rupture associated with the use of misprostol during second trimester pregnancy termination in primigravida Archives of Perinatal Medicine 2015; 21(1): 57-59.
Uterine rupture is the disruption of all the layers of the uterus including the myometrium and serosa.
There are signs that postpartum hemorrhage, stillbirth and the risk of
uterine rupture increase in subsequent births among patients who underwent planned CSs in their previous births when compared to those who underwent emergency CS.1 Gasim et al.17 found that blood loss and the need for blood transfusion increased in patients with four or more CSs compared to patients with two to three CS.
The risk of
uterine rupture after myomectomy: a systematic review of the literature and meta-analysis.
Obstetricians worry about
uterine rupture during VBAC, even though the actual rate of
uterine rupture is approximately 1%.[6] A long duration of labor may increase the risk of
uterine rupture; as such, it is recommended that obstetricians should avoid excessively long periods of labor during VBAC by shortening the second stage of labor by operative vaginal delivery and by reducing the occurrence of fetal distress.[20]
Hersh and her coinvestigators found that, in the theoretical cohort, "laboring upright led to 64,890 fewer cesarean deliveries, 15 fewer maternal deaths, 113 fewer
uterine ruptures, and 30 fewer hysterectomies."
Despite global effort to improve obstetric care,
uterine rupture is still causing maternal deaths in developing countries particularly in sub-Saharan Africa where there is inadequate medical care or limited access due to various reasons [1,8].
And the result presented can have significance in devising appropriate preventive strategies in preventing occurrence and complication of
uterine rupture for health professionals and health planner as well.
Although it may occur in an unscarred uterus, the most common cause of
uterine rupture is splitting of a previous cesarean scar.
Scar pregnancies with minimal or absent overlying myometrium are typically diagnosed in the first trimester and carry increased risk of hemorrhage and
uterine rupture. (1,3,6,9,11,12) Less severe cases may be diagnosed as placenta accreta in the second and third trimesters.
Uterine rupture is both intra-operative and one of the late complications of hysteroscopy.
Clinically, rupture of pelvic (uterine) varicose vein mostly mimics placental abruption or
uterine rupture (13).