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Uterine rupture is a frightening and dangerous emergency condition that most often occurs during pregnancy, at time of labor. In it, part of the uterus rips or tears, which frequently causes the fetus to be expelled into the abdominal cavity of the body. This tear is immediately life threatening for baby and mother.
The mother’s body is busy pumping extra blood to the uterus to supply its demands during pregnancy, so blood loss is profound. The baby is also at significant risk because it is unprotected if it is outside the womb environment. Though mother and child may both survive uterine rupture, emergency treatment is needed to make certain.
Very often, women are more at risk for this condition if they are attempting a vaginal birth after cesarean section (VBAC). While the incidence of uterine rupture is still unlikely, the condition is most likely to occur here, especially under certain circumstances. From study of the literature, it is known that highest risk groups of VBAC patients are those who use pitocin and/or prostaglandins to induce labor. A women trying for a VBAC may be discouraged from planning an induced labor. The reason a c-section poses addition risk is because there is scarring in the uterus from previous operations, which could break open or rupture.
This situation might also occur in women who have never had a c-section. Having more than five vaginal births, or being exposed to extreme trauma, such as a car accident or crushing injury, could cause a spontaneous rip in the uterus too. Higher multiple births or accumulation of too much amniotic fluid poses some risk, also. Generally, people who have VBAC are more at risk, and need to weigh this carefully with a doctor prior to determining which labor strategy is best.
The usual procedure for handling uterine rupture is emergency c-section to deliver the baby, and to begin repair of the uterus. Sometimes repair is not possible and severe hemorrhage is treated by hysterectomy, removal of the uterus. Despite treatment, and particularly if rupture doesn’t occur in the hospital setting, mortality is still possible for child and mother. Of most concern is the fact that this condition still represents about 5% of labor-related deaths in mothers.
Fortunately, there are many more women who experience uterine rupture and survive it, leaving the hospital with their new children. Plans for the first few weeks after pregnancy should be slightly altered. At minimum women will need to recover from a c-section and possibly from a hysterectomy. This may mean women could require more help in taking care of a newborn the first few weeks, which can promote plenty of rest time so that both mom and baby thrive.
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