Uterine rupture: a revisit

Authors

  • Madhavi Manoharan MRCOG,

    Clinical Fellow, Fetal Medicine, Corresponding author
    1. Department of Obstetrics and Gynaecology, Homerton University Hospital NHS Foundation Trust, Homerton Row, London E9 6SR, UK
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  • Rekha Wuntakal MRCOG,

    Specialist Registrar in Obstetrics and Gynaecology
    1. Department of Obstetrics and Gynaecology, Homerton University Hospital NHS Foundation Trust, London, UK
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  • Katrina Erskine MD MRCP MRCOG

    Consultant Gynaecologist
    1. Consultant Obstetrician and Gynaecologist, Department of Obstetrics and Gynaecology, Homerton University Hospital NHS Foundation Trust, London, UK
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Department of Obstetrics and Gynaecology, Homerton University Hospital NHS Foundation Trust, Homerton Row, London E9 6SR, UK Email: madhumano70@yahoo.co.uk

Abstract

Key content

  • Uterine rupture is an uncommon complication of pregnancy associated with potentially catastrophic consequences for both mother and baby.
  • Previous uterine surgery is the most common underlying cause; however, multiparous women without uterine scarring are also at risk if labour becomes obstructed.
  • A review of CEMACH reports has shown a consistent decrease in maternal mortality secondary to uterine rupture despite increasing caesarean section rates.
  • The risk of uterine rupture during attempted vaginal birth after caesarean section is widely recognised; however, there needs to be greater awareness of this emergency occurring in multiparous women undergoing induction/augmentation of labour.

Learning objectives

  • To define uterine rupture.
  • To examine the causes and risk factors for antepartum and intrapartum uterine rupture.
  • To review the signs and symptoms.
  • To revise the management of uterine rupture.
  • To increase awareness of this very serious complication and to suggest how clinicians can make a case-based individual assessment of uterine rupture risk.

Ethical issues

  • Are those women at risk of uterine rupture adequately counselled about the possibility and potential consequences?

Please cite this article as: Manoharan M, Wuntakal R, Erskine K. Uterine rupture: a revisit The Obstetrician & Gynaecologist 2010;12:223–230.

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