Birth complications: cervical rupture and its consequences. Cervical rupture during childbirth: causes, treatment tactics and possible consequences

is a pathological condition that is characterized by a violation of the integrity of the walls of the uterus during labor activity. The main clinical manifestations include sharply painful, intensified contractions, difficulty urinating, signs of blood loss and the erectile or torpid phase of shock. Diagnosis of uterine ruptures is based on preliminary collection of anamnesis and identification characteristic symptoms, if necessary, ultrasound data. Therapeutic tactics consist of delivery by cesarean section, midline laparotomy or fetal destruction operations with stopping bleeding, stitching the rupture or extirpation of the uterus in the future.

General information

Uterine rupture is a violation of the integrity of the uterus during pregnancy or childbirth. First this pathology was described back in the 16th century. Currently this is one of the least common pathological conditions in obstetrics. The overall incidence of uterine rupture ranges from 0.1-0.01% of all births. Only 8-10% of ruptures occur before labor begins. In the first and second trimesters, this pathology is rarely observed. At the same time, uterine ruptures are characterized by high rates of maternal and perinatal mortality - 3-5% and 35-40%, respectively. In modern obstetrics, the leading role is given to prevention through early detection potential etiological factors and rational selection of the method of delivery against their background.

Causes of uterine rupture

On this moment There are several options for the etiopathogenesis of uterine rupture during childbirth: a mechanical barrier to the fetus, histological changes in uterine tissue and force. The first group includes all anatomical and physiological characteristics of the mother and/or fetus that complicate or make it impossible for the child to pass through the female birth canal. Rupture of the uterus can be caused by an extensor or transverse position, asynkylitic insertion of the head, hydrocele, large fetus, abnormal development of the pelvic bones, and the presence of neoplasms of the genital tract.

Histological changes are currently the most common cause of uterine rupture - over 90% of all cases. This group includes the presence of scars or areas of trophic changes in the myometrium after more than 3 births, including with complications, multiple curettages, cesarean sections or other operations on the uterus, frequent endometritis. The development mechanism is based on the loss of elasticity of tissues or their weakness and, as a result, the inability to withstand the load. Forced uterine rupture caused by obstetric aids or surgery is rare. The cause of rupture in such cases is the application of excessive pressure on the uterus by the hands of a doctor or medical instruments. Uterine rupture can be caused by non-compliance with the technique of the operation, the use of the Kristeller maneuver, prolonged stimulation with oxytocin, and rotation of the fetus with advanced transverse presentation.

Classification of uterine rupture

Depending on the pathogenesis, uterine ruptures are divided into:

• Spontaneous. These are ruptures that occur independently, against the background of anatomical and physiological characteristics of the mother and/or child (mechanical obstruction, histological changes).
• Violent. Such uterine ruptures are the result medical actions(use a vacuum extractor, forceps, too quick birth child), abdominal and pelvic injuries.

Based on the degree of damage to the wall, uterine ruptures can be divided into two groups:

• Complete uterine ruptures, which damage the endo-, myo-, and perimeter. This creates an opening between the uterine and abdominal cavities through which the fetus can emerge.
• Incomplete uterine ruptures are limited only to the endometrium and/or myometrium. The main manifestation is the formation of a hematoma under the visceral peritoneum or between the leaves of the broad ligament.

Symptoms of uterine rupture

Uterine rupture can be in one of 3 stages: threatening, beginning or completed. This division is due to the sequence of violations of the integrity of the walls of the uterus and the clinical manifestations that arise against this background. With a threatening uterine rupture, the clinical picture is caused by excessive stretching of the tissues, but their integrity is still preserved. The leading symptoms of this stage: severe pain in the hypogastrium, increased intensity and shortened pauses between contractions, increased heart rate and RR, low-grade fever, urinary retention, swelling of the external genitalia. In the middle third of the abdomen or slightly higher, a contraction ring can be detected by palpation. With threatening uterine rupture, fetoplacental blood flow worsens, fetal hypoxia occurs, which leads to damage to the central nervous system or even death of the child.

The onset of uterine rupture is characterized by disruption of the integrity of the endometrium and myometrium, damage to arteries or veins and the formation of a hematoma. Clinical manifestations This stage includes convulsive contractions with pronounced pain syndrome, bloody or bloody vaginal discharge and blood in the urine. This condition often leads to the development of shock. Its initial (erectile) stage is accompanied by general arousal, strong fear, screaming and mydriasis. Often, the onset of uterine rupture ends in the death of the child due to prolonged hypoxia.

A completed uterine rupture is manifested by a complete rupture of the wall. At the same time, the pressure of the fetus on the genital tract suddenly disappears. Clinically, this is characterized by increased pain at the height of one of the contractions, after which labor stops completely. The previously occurring shock passes from the erectile phase into the torpid phase, signs of massive blood loss appear: severe pallor of the skin, shallow breathing and thread-like pulse, “collapse” of blood pressure, retraction eyeballs, vomiting, clouding and loss of consciousness. Against the background of a complete rupture of the uterus, the child may go into abdominal cavity. In such cases, parts of the fetus are clearly palpated under the abdominal wall, and the fetus itself is displaced above the entrance to the pelvis.

Diagnosis of uterine rupture

Diagnosis of uterine rupture is based on medical history and physical examination of the woman in labor, and, if necessary, ultrasound results. In most cases, the time to make a diagnosis is very limited, since uterine rupture is an urgent condition that requires immediate medical intervention. In case of incorrect interpretation of identified symptoms, incorrect or late determination of the nature of the pathology, the risk of death of both the child and the mother increases significantly.

When interviewed, women pay attention to character pain, the presence of discharge from the genital tract, previously suffered gynecological diseases and operations, features of previous births. As a rule, the risk of developing uterine rupture is assessed before the onset of labor, including based on the results of an ultrasound scan. The obstetrician-gynecologist attending the birth must be informed about the results. During a physical examination of a woman with suspected uterine rupture, blood pressure, respiratory rate and heart rate are assessed, and the abdomen is palpated. Next, an external obstetric examination is performed to assess the size and tone of the uterus and the position of the fetus in it. If the result of a physical examination is questionable, a control ultrasound scan may be performed. Ultrasound makes it possible to assess the thickness of the walls of the uterus and identify a violation of their integrity, determine the stage at which the uterine rupture is located. To assess the vital functions of the fetus, cardiotocography can be performed.

Treatment of uterine rupture

Therapeutic tactics for uterine rupture are reduced to the fastest possible delivery and stopping bleeding. In all cases this state is a direct indication for immediate surgical intervention. Regardless of the stage, the volume of blood volume is replenished by intravenous infusion of blood products or blood substitutes and the prevention of bacterial complications with the help of antibacterial agents.

In a state of threatening uterine rupture, labor activity of the uterus is immediately stopped. This is ensured by drug muscle relaxation against the background general anesthesia. Next, depending on the presence of signs of fetal vital activity, C-section or craniotomy. When a uterine rupture has begun and completed, a median laparotomy is indicated for the purpose of a full revision of the abdominal and uterine cavities. This access also allows for excision of edges and stitching of small tears or extirpation in case of massive damage, infection or multiple crushed tissues. In case of incomplete uterine ruptures, the hematoma is emptied and hemostasis is performed.

Forecast and prevention of uterine rupture

The prognosis for a woman with uterine rupture directly depends on the severity of the damage, the amount of blood loss and the state of the art of care. The prognosis for a child with complete uterine rupture, as a rule, remains unfavorable, which is due to placental abruption. Preventive measures in relation to uterine ruptures, they imply the preliminary exclusion of all circumstances in which there is an excessive impact on the walls of the organ. To do this, a pregnant woman must regularly visit an antenatal clinic and undergo a full examination. If there are factors that could potentially cause uterine rupture, the method of delivery is selected individually by the treating obstetrician-gynecologist.

The uterus is female organ, without which procreation would be impossible. It is in it that the development and gestation of the fetus occurs. During the birth process, the cervix plays one of the main roles. Their results directly depend on how quickly it opens. Due to the active contraction of the uterine muscles during contractions, the fetus moves towards the pharynx and is pushed out. The process of the baby passing through the cervix is ​​facilitated by pushing.

Despite the naturalness birth process, complications sometimes occur in obstetric practice. One of them is cervical rupture during childbirth.

Many doctors say that damage occurs when a woman pushes incorrectly without listening to instructions. medical personnel. In such cases, active attempts begin before the cervix has time to open. The result is ruptures of varying degrees.

Symptoms depend on the cause, type, stage and extent birth trauma. This can happen both during and after childbirth. On general condition And clinical picture also reflects the presence concomitant diseases, infections, mental condition women.

Trauma to the cervix is ​​accompanied by internal and external bleeding.

Depending on the size of the damage, it can be massive or scanty; the woman in labor experiences bloody issues with clots. There is also abundant cold sweat, weakness, pallor. With minor damage (up to 1 cm), there are often no symptoms.

If injury occurs during childbirth, it can be combined with rupture of the uterus itself, which significantly changes the clinical picture. In this situation, the woman behaves restlessly, labor becomes overly active and is accompanied by severe painful contractions.

The uterus becomes deformed like an hourglass, swelling of the cervix, vagina and vulva appears.

When uterine rupture begins, the clinical picture is accompanied by convulsive contractions, bloody or bloody discharge from the vagina, and blood in the urine. When the rupture has already occurred, after a sudden sharp pain in the abdomen and burning, labor stops.

Due to pain and hemorrhagic shock a woman experiences:

• depressed state;
• pale skin;
• sweating;
• nausea and vomiting;
• a fall blood pressure;
• rapid pulse.

After uterine rupture, the fetus can be palpated in the abdominal cavity. The complication leads to the death of the child, so his heartbeat at this moment can no longer be heard.

Classification of ruptures

The cervix ruptures more often in the direction from bottom to top, that is, from the outer to the inner edge of the pharynx. Organ damage can occur before, during, and after childbirth. If a rupture occurs after childbirth, the cervix is ​​usually only slightly injured.

There are unilateral and bilateral injuries; they come in three degrees of severity. Small tears (up to 2 cm) are classified as grade I; grade II is characterized by a size of more than 2 cm, but the injury does not reach the vagina. In degree III, tissue divergence reaches the vaginal vault or extends to it. The most serious clinical case a cervical rupture extending into the body is considered reproductive organ.

Causes and risk factors

Birth ruptures can occur due to the woman’s fault or be the result of injury from medical forceps, as well as the result of rough palpation of the uterus and other actions of the doctor. But there are several predisposing factors.

The prerequisite for ruptures is poorly treated genital infections, which reduce the elasticity of the walls of the cervix. In addition, ruptures are almost inevitable during rapid labor.

Active early attempts and contractions with insufficient dilatation can lead to serious breaks not only the cervix, but also the body of the uterus itself.

With sluggish attempts, labor is stimulated special drugs, which also contributes to organ injuries. For women who have previously practiced gymnastics or dancing, it is typical increased tone pelvic muscles, which also contributes to ruptures due to improper management of labor.

Consequences of injury

Cervical rupture is mainly diagnosed after the birth of the baby and placenta. The doctor carefully examines the woman using mirrors to identify injuries and prevent complications.

In case of untimely diagnosis, poor-quality stitching or improper care behind the stitches, cervical ruptures during childbirth cause serious consequences:

1. Suppuration of wounds. Poor quality service medical care leads to sepsis, which can lead to removal of the uterus or death.
2. The appearance of a postpartum ulcer.
3. Spontaneous scarring, forming an inversion of the cervix.

Most often, ruptures are isolated, without transfer to the body of the uterus, and occur in the second stage of labor. In such cases, the outcome is usually favorable for both the mother and the child. However, the consequences when serious injuries can only be avoided if timely diagnosis and emergency care.

Any untreated damage threatens the appearance and development of chronic inflammatory processes and even cancer. Also, rupture of the cervix during childbirth can provoke consequences in the form of isthmic-cervical insufficiency.

This makes carrying subsequent pregnancies more difficult, increased or premature appearance baby into the world.

Treatment for cervical rupture

Treatment begins immediately after ruptures are detected. The main method for eliminating damage is surgical intervention. Lacerations are sutured using absorbable sutures under general or local anesthesia.

Sewing starts from top corner rupture, heading towards the external pharynx. If the tissue divergence has spread to the body of the uterus, a laparotomy is performed and the issue of extirpation (removal) or preservation of the organ is decided.

At repeated births with the presence of old tears, plastic surgery is performed using a special technique. Dead and scarred tissue is cut off, and when stitching, the mucous membrane is carefully stretched to form a new, more even scar and prevent future deformation.

In addition to surgical intervention, in case of heavy blood loss, intravenous infusions with hemostatic drugs and saline are indicated. To prevent infection and the development of inflammation, antibiotics and local antiseptics are prescribed.

Sexual relations are prohibited in the next 2 months after suturing. If you follow your doctor's instructions, the consequences of cervical rupture will be minimal.

Prevention

Preventive measures to prevent injury to the cervix include both the professional actions of the doctor and the attentive attitude of the mother to her health. When planning a pregnancy, it is necessary to carefully examine and treat all chronic diseases.

To prevent cervical rupture during childbirth, you should exercise special gymnastics to strengthen the vaginal muscles, take vitamins and minerals, eat right and get proper rest. It is recommended to enroll in courses for expectant mothers.

During the birth process, a woman should listen carefully to the midwife and doctor, and push according to their instructions.

Proper breathing plays an important role. Timely, sufficient in depth and rhythm breathing movements reduce pain and allow you to concentrate on labor.

To reduce pain and prevent premature pushing, painkillers are used. In order to ensure normal dilatation of the uterus, antispasmodics are prescribed.

The obstetrician leading the birth should not make sudden movements when using medical instruments or removing the fetus during breech presentation, since injury in such situations is almost inevitable.

It should be taken into account that in patients with a history of damage to the reproductive organs, the risk of recurrence of the situation increases significantly.

So that subsequent births after cervical rupture take place without serious consequences, the woman should follow all the recommendations of the obstetrician-gynecologist. Coherence in the team of doctors and women in labor is the key natural birth with a favorable outcome.

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WITH anatomical point it's just a matter of sight component organ. It is part of the uterus - upper section the female genital tract, one of the main organs that participate in the birth of a child.

Cervix- this is its lower section, which serves as a distinction between the upper and lower sections of the genital tract.

The cervix itself also has certain levels of its structure, is divided into the vaginal and uterine parts, into the exocervix and endocervix, and there is also cervical canal, which is the wire path between the vagina and the uterine cavity.

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The cervix is ​​more difficult from the point of view histological structure. It contains the junction of two functionally important epithelium: multilayered squamous and cylindrical. Exactly this area important, since it is where development most often occurs malignant process.

Functions of the cervix

In addition, the cervix is important part V reproductive system in terms of its functions:

Cervical rupture

Cervical rupture is a fairly common pathology in obstetric practice; in gynecology it is much less common, and can only be associated with traumatic effects, as well as possible sealing of the myomatous node.

During childbirth, this pathology occurs more often. The risk group for cervical ruptures includes primiparous women; multiparous women have much fewer cases of ruptures.

Causes

The reasons can be very different, among them are:

Such reasons are more typical when there is excessive load on internal os, through which the process of giving birth to a child begins.

But in some cases, the rupture begins in the area of ​​the external pharynx; this usually occurs when:

Risk factors

There are quite a lot of them, but they may not always lead to ruptures:

Types of breaks

Spontaneous ruptures

Spontaneous ruptures occur independently during natural childbirth.

Among them there are divisions into the causes that cause one or another cervical rupture:

• Against the background of morphological damage to the cervical tissue. At inflammatory processes, diseases connective tissue, as well as the presence of previous scar changes.
• Against the background of a mechanical obstacle. Occur when there is tumor process, as well as placenta previa.
• Mixed form. In which there is a combination of morphological and mechanical obstacles to the process of natural childbirth. This group includes the birth of a large child with an insufficiently prepared cervix or in an extension position, as well as discoordination processes in the cervix.

In turn, they can be divided into several more stages of the pathological process:

• Possible rupture.
• Stage of threatening rupture. Process in progress tissue tension with impaired blood supply and spasm.
• The stage of the rupture that occurred.

Violent breakup

This type is the most dangerous.

It happens like this:

• Pure violent break. In this case, external trauma is possible, as well as vaginal delivery surgery. The most common cause in this case is vaccumextraction, as well as the application of obstetric forceps.
• Mixed cervical rupture. It is formed as a result of a combination of rough mechanical interventions and the presence of morphological damage to the cervical tissue with mechanical compression.

According to the presence of complications:

• Complicated. Ruptures accompanied by the transition of the process to the vaginal vaults, as well as possible parametric tissue. Typically, such cervical ruptures are accompanied by heavy bleeding And possible risk inflammatory process.
• Uncomplicated. These are small tears including 1st and 2nd degree.

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Degree of cervical rupture

Currently, experts distinguish several degrees of cervical rupture:

Such conditions are considered serious organ damage and require surgical intervention with the transition to laparotomy. Procedures are carried out under general anesthesia. In some cases, assistance from specialists in a related field may be required. In the event of a rupture, the woman feels severe pain in the perineal area or lower section belly. It can be so intense that it leads to painful shock.

Diagnostics

As a rule, uterine ruptures do not go unnoticed by the doctor. But in some cases this is possible, especially since the cervix is ​​the part that may not manifest itself as severe pain.

Diagnostic stages:

When diagnosing cervical ruptures severe Consultation with anesthesiologists, therapists and surgeons is also required.

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Treatment

This is quite a serious and responsible process. The choice of tactics depends on the specialist immediately after the onset of childbirth, since untimely treatment begins leads to the development of serious complications.

The volume will depend on the nature of the damage, as well as the volume, complications and possible negative factors.

After assessing the extent of damage, the treatment process occurs.

The main one is surgical suturing of damaged tissues:

Consequences

This is enough actual topic, because it is she who can affect not only a woman’s health, but also the further possibility of childbearing.

Complications include early changes occurring in a woman’s body:

Long-term consequences include:

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• Increased risk of developing isthmic-cervical insufficiency. Which will lead to miscarriage.
• Loss protective properties, this predisposes to further development chronic inflammation in the uterine cavity.
• Development of infertility.
• Decreased activity during sex.
• Increased risk of developing a malignant process in the area of ​​epithelial junction.
• Development of cervical inversion, as well as possible subsequent uterine inversion.

Prevention

This is a whole set of measures aimed at preventing the development of gaps. In most cases, it should be carried out in advance, but not only at the stage of pregnancy planning, but throughout the woman’s life.

Prevention measures:

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Rupture of the cervix during childbirth complicates the course of labor in 6 women out of a hundred, while during the first birth this happens 4 times more often.

The consequences can be very serious if healing is poor or for some reason the wound is not sutured.

The causes of cervical rupture are varied:

1. Inadequate management of the second stage of labor, often due to the fault of the woman in labor herself. At the end of the first stage of labor, when the genital organ is not yet fully dilated, the moment comes when the first attempts come, an irresistible, strong desire push down, however, since the cervix has opened only 8 cm, pushing can lead to damage to it, you cannot push, you need to breathe through this period. If a woman in labor is allowed to push ahead of time or does not listen to the medical staff, rupture becomes a very possible complication.

2. A decrease in the elasticity of the cervix, which leads to its incomplete dilatation, sufficient for the birth of a child, but not sufficient for this to happen without complications. The reasons for this may be as follows: late age women in labor for the first birth, and in other conditions that reduce the elasticity of tissues, for example, the presence of scars after abortions and previous births, operations on the cervix, and other traumatic and infectious injuries.

3. Features of childbirth. Problems occur during childbirth with a large fetus, during breech birth, and during the provision of obstetric care (operative childbirth). Discoordination of labor activity contributes to pathologies, or, on the contrary, labor occurs too quickly.

Classification of cervical ruptures.

There are three degrees of damage. Usually the damage is localized on the sides of the hollow muscular organ on both sides.

Grade 1 - occurs most often, with the cervix having damage not exceeding 2 cm in length.
2nd degree - the wound is deeper than 2 cm, but does not extend to the vaginal wall.
3rd degree - tissue damage extends to the vaginal vaults.

Damage to the cervix is ​​manifested by the development of usually minor bleeding immediately after the birth of the child, and without examination of the soft birth canal it is not diagnosed. With 3rd degree ruptures, blood may accumulate in the soft tissues, the tissue around the uterus, this is dangerous. A parametric hematoma is formed, its symptoms are pain and a feeling of fullness in the pelvic area and perineum.

If the wound is left unsutured, the consequences can be quite serious. The female genital organs are capable of healing on their own, but the edges of the rupture may be everted or incorrectly aligned, this is called ectropion of the cervix. By and large, this is erosion that will bother you until it is eliminated. surgically. In this case, childbirth may be complicated by repeated ruptures, pregnancy may be complicated by isthmicocervical insufficiency and miscarriage. All these are the consequences of unsutured ruptures after childbirth and poor healing.

At timely treatment in the required amount, any internal damage during childbirth ends full restoration shape and function of the cervix.

"Old wounds", if not treated correctly, can manifest themselves as erosion, or even ectropion. These are contact bleeding (bloody discharge after sex), recurrent colpitis and inflammatory diseases(cervicitis). Long-term ectropion cannot be treated conservative treatment, and may even entail cancer, reconstructive surgery on the cervix is ​​required. “Old wounds” and pregnancy repeatedly create the risk of miscarriage, since the ability of the reproductive organ to hold the fetus is impaired, under load it begins to open ahead of time, and at the same time, due to the scar and decreased elasticity, it can rupture again during childbirth, since will not be able to fully open up.

All women are examined by a doctor immediately after the birth of the child and the separation of the placenta, and the degree of damage to the soft birth canal is assessed. At that point you won’t care; the procedure is easy to bear. Injuries of the 1st degree, and often the second, are sutured without any anesthesia at all; it is not necessary, since there are no nerve receptors in this area. It can only be unpleasant because the birth canal is painfully stretched; treatment comes down to careful comparison of the edges of the tear and suturing with restoration of the anatomy of the cervix; catgut sutures are placed that do not require further removal from the vaginal vault to the internal os.

Uterine rupture is the most dangerous complication during childbirth and almost always leads to the death of the child as a result of a sudden cessation of oxygen access due to placental abruption. Fortunately, in modern obstetrics such complications are extremely rare.

Types of uterine ruptures during childbirth

Depending on the extent of the violation of the integrity of the uterine walls, a distinction is made between complete and incomplete rupture. In the first case, all the membranes of the uterus rupture and the fetus enters the abdominal cavity. With an incomplete rupture, only one layer of the uterine lining is torn, and if doctors provide timely assistance to the mother and child, the death of both can be avoided.

In addition, uterine ruptures are classified into spontaneous and forced. Spontaneous rupture develops due to certain reasons, while violent rupture occurs due to pressure on the abdomen during childbirth, injuries, blows to the anterior abdominal wall. Most often, a violation of the integrity of the lining of the uterus occurs in the lower third of the organ, where the tissues are maximally stretched or thinned.

By clinical course gaps are distinguished:

• threatening;
• started;
• happened.

Causes of uterine rupture during childbirth

The most common causes of uterine ruptures during childbirth are the following:

• Large fruit (fruit weight more than 4000 g);
• Multiple pregnancy;
• Polyhydramnios;
• Anatomical features of the structure of the uterus, for example, with bicornuate organ;
• The presence of scars on the uterus after previous cesarean sections, previous operations, surgical abortions long term;
• women;
• Incorrect position of the fetus in the uterus, presentation;
• Titanic contractions of the uterus as a result of hyperstimulation by oxytocin.

Signs of threatened uterine rupture during childbirth. Symptoms and diagnosis of uterine rupture after childbirth

An obstetrician-gynecologist is constantly with the woman in the delivery room, which is necessary in order to notice in time threatening conditions and provide immediate assistance. Signs of impending uterine rupture include the following:

• Excessive and incessant contractions of the uterus;
• Sharp pain on palpation in the area of ​​the lower third of the organ;
• The uterus takes on the shape of an hourglass, its upper and lower segments are located obliquely from each other;
• Ichor is secreted from the genital tract;
• When examining the genital organs, the doctor notes their swelling.

If the threatening rupture is caused by thinning of the walls of the uterus in the area of ​​the lower segment of the organ, then the woman will experience a weakening of labor.

Symptoms of uterine rupture during childbirth are:

• The woman behaves restlessly, clutches her stomach with her hands, complains of piercing pain;
• Blood pressure readings drop sharply;
• The skin of a woman in labor is pale, cold sweat appears, the pupils dilate, the pulse becomes thread-like;
• Shortness of breath and loss of consciousness appear.

Consequences of uterine rupture during childbirth

Almost always, after a uterine rupture during childbirth, a woman has her uterus removed, so she will no longer be able to have children. The serious consequences of this complication are massive hemorrhages in the abdominal cavity, painful shock, acute vascular and heart failure in women. If a woman in labor is not given emergency treatment in a timely manner surgery, then maybe death her and the child.

Rupture of the uterine scar after surgical delivery

They always try to admit a woman who has undergone surgical delivery to the maternity hospital in advance, approximately 1-2 weeks before the expected date of birth. Throughout pregnancy, doctors pay close attention to the scar on the uterus. Immediately before giving birth, the patient is once again sent for an ultrasound to control the condition of the scar - its stretching, thickness, and surrounding tissues. If the scar is incompetent, then the woman undergoes a repeat cesarean section, and the operation is scheduled a week earlier before the expected due date. Such measures are due to the danger of uterine tissue diverging along the old scar during contractions or pushing, so obstetricians prefer not to take risks.

If, however, the scar ruptures during pregnancy or during childbirth, then the woman undergoes emergency surgery. When tissue ruptures, the pregnant woman feels piercing pain in the abdomen, loss of consciousness is possible, and blood pressure levels drop. If no assistance is provided future mom may die from painful shock and blood loss, and the child from acute hypoxia.

Rehabilitation period after uterine rupture

IN rehabilitation period after a uterine rupture during childbirth, a woman is shown strict bed rest on the first day. Afterwards, she can get out of bed with the help of medical personnel to prevent the development of adhesive disease.

Since with this complication the woman loses a lot of blood, then for speedy recovery She is prescribed antianemic drugs, drugs that prevent the formation of clots. During the recovery period, it is strictly forbidden to lift weights and be sexually active.

Irina Levchenko, obstetrician-gynecologist, especially for website

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