Signs and Symptoms of Uterine Rupture During Pregnancy

According to Medscape, 2012 The classic signs and symptoms of uterine rupture are (1) fetal distress (as evidenced most often by abnormalities in fetal heart rate), (2) diminished baseline uterine pressure, (3) loss of uterine contractility, (4) abdominal pain, (5) recession of the presenting fetal part, (6) hemorrhage, and (7) shock. However, modern studies show that some of these signs and symptoms are rare and that many may not be reliably distinguished from their occurrences in other, more benign obstetric circumstances.ConditionTotal CasesCases With Uterine RuptureIncidence

in Patients

With Uterine Rupture, %

Years

of Data Collection

No.

of Studies

References

Abnormal pattern in fetal heart rate344187541973-20028Gardeil 1994, Golan 1980, Rahman 1985, Blanchette 2001, Taylor 2002, Rageth 1999, Yap 2001, Bujold 2002

Prolonged deceleration in fetal heart rate or bradycardia143114801983-20024Miller 1994, Leung 1993, Bujold 2002, Menihan 1998

Uterine tachysystole*or hyper-stimulation3012401994-19992Blanchette 2001, Phelan 1998

Loss of intrauterine pressure or cessation of contractions144641973-19993Golan 1980, Blanchette 2001, Eden 1986

Abnormal labor or failure to progress16949291983-19962Rageth 1999, Leung 1993

Abdominal pain454118261931-20009Golan 1980, Rahman 1985, Blanchette 2001, Yap 2001, Leung 1993, Miller 1997, Bujold 2002, Rodriguez 1989, Eden 1986

Vaginal bleeding381140371931-20008Gardeil 1994, Golan 1980, Rahman 1985, Yap 2001, Leung 1993, Miller 1997, Bujold 2002, Eden 1986

Shock21371331931-19933Golan 1980, Rahman 1985, Eden 1986

*Defined as > 6 contractions during 2 consecutive 10-minute periods of observation.

Common warning signs of imminent uterine rupture Frequent, strong uterine contractions, occurring more than 5 times in every 10 minutes, and/or each contraction lasting 6090 seconds or longer. Fetal heart rate above 160 beats/minute, or below 120 beats/minute, persisting for more than 10 minutes this is often the earliest sign of obstruction affecting the fetus. Bandls ring formation Tenderness in the lower segment of the uterus. Possibly also vaginal bleeding.

Picture : A normal abdominal contour (left) and an obstructed uterus with Bandls ring (right), indicating imminent risk of rupture.Window period This is the time between original infection with HIV and the appearance of Detectable antibodies to the virus, normally a period of about 14-21 days. (WHO, 2013)The interval that elapses between infection or inoculation with a pathogen and the onset of symptoms or of detectability of infection by laboratory testing.

The time between infection with a bloodborne virus and the appearance of specific laboratory evidence of infection in a specimen of blood obtained from the asymptomatic host for the purpose of diagnostic screening, or in blood or blood products donated by the host.Golden PeriodA time span during which an injury or other potentially urgent condition may go untreated without harmful effects. (Segen's Medical Dictionary, 2012)

REFERENCESNahum G.G. 2012. Uterine Rupture in Pregnancy. Available on http://emedicine.medscape.com/article/275854-overview#aw2aab6b3. Viewed on January, 19th 2013 (17:24)The Open University. 2012. Rupture Uterus. Available on http://labspace.open.ac.uk/mod/oucontent/view.php?id=452788&section=1.5.1. Viewed on January, 19th 2013 (17:24)