Uterine rupture: Difference between revisions
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==Background== | ==Background== | ||
* | Prevalence | ||
* | *No prior c-section = 0.01% | ||
* | *Prior c-section = 0.2-0.8% | ||
* | Risk factors | ||
* | *Prior c-section (major) | ||
*Malpresentation | |||
*Labor dystocia | |||
*Hypertension | |||
*Bicornuate uterus | |||
*Grand multiparity | |||
*Connective tissue disorder | |||
*Placenta percreta | |||
*Prior myomectomy | |||
*Misoprostol use (oxytocin likely safe) | |||
*Typically occurs during labor | |||
==Diagnosis== | ==Diagnosis== | ||
Revision as of 16:47, 20 January 2016
Background
Prevalence
- No prior c-section = 0.01%
- Prior c-section = 0.2-0.8%
Risk factors
- Prior c-section (major)
- Malpresentation
- Labor dystocia
- Hypertension
- Bicornuate uterus
- Grand multiparity
- Connective tissue disorder
- Placenta percreta
- Prior myomectomy
- Misoprostol use (oxytocin likely safe)
- Typically occurs during labor
Diagnosis
- Ultrasound: abdominal free fluid, uterine defect
- Maternal Clinical
- Persistent abdominal pain with peritoneal signs
- Vaginal bleeding
- Maternal shock
- Loss of fetal station
- Palpable uterine defect
- Fetus
- Bradycardia
- Fetal heart decels
- Fetal demise
Differential Diagnosis
Vaginal Bleeding in Pregnancy (>20wks)
- Emergent delivery
- Placental abruption
- Placenta previa
- Vasa previa
- Uterine rupture
- Preterm labor
- Vaginal trauma
- Placenta accreta
- Intrauterine fetal demise
3rd Trimester/Postpartum Emergencies
- Acute fatty liver of pregnancy
- Amniotic fluid embolus
- Chorioamnionitis
- Eclampsia
- HELLP syndrome
- Mastitis
- Peripartum cardiomyopathy
- Postpartum endometritis (postpartum PID)
- Postpartum headache
- Postpartum hemorrhage
- Preeclampsia
- Resuscitative hysterotomy
- Retained products of conception
- Septic abortion
- Uterine rupture
Management
- Fluid resuscitation
- Blood product replacement
- Emergent delivery of fetus
See Also
Source
Tintinalli