Uterine rupture: Difference between revisions
User238345 (talk | contribs) (Background update) |
User238345 (talk | contribs) (Diagnosis update) |
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==Diagnosis== | ==Diagnosis== | ||
*Ultrasound | *Ultrasound | ||
**Disruption of myometrium | |||
**Free peritoneal fluid (FAST+) | |||
**Anhydramnios/empty uterus | |||
**Herniated amniotic sac | |||
**Fetal anatomy outside of uterus | |||
**Absence of FHR | |||
*Maternal Clinical | *Maternal Clinical | ||
**Persistent abdominal pain with peritoneal signs | **Persistent abdominal pain with peritoneal signs | ||
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**Loss of fetal station | **Loss of fetal station | ||
**Palpable uterine defect | **Palpable uterine defect | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 16:52, 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
- Disruption of myometrium
- Free peritoneal fluid (FAST+)
- Anhydramnios/empty uterus
- Herniated amniotic sac
- Fetal anatomy outside of uterus
- Absence of FHR
- Maternal Clinical
- Persistent abdominal pain with peritoneal signs
- Vaginal bleeding
- Maternal shock
- Loss of fetal station
- Palpable uterine defect
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