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Risk factors for uterine rupture

A straightforward pregnancy is every Massachusetts mother’s hope, but complications such as uterine ruptures can arise quickly, be difficult to diagnose and have catastrophic consequences. Although uterine ruptures are rare, physicians must respond rapidly when one does occur to minimize the possibility of severe injury or death for both mother and child.

A uterine rupture occurs when pressure during labor tears the uterus, according to Healthline. The biggest resulting threat to the mother is the potential for hemorrhage, although in a hospital setting, fatal blood loss is unlikely. The risk to the baby is much greater because a rupture may lead to oxygen deprivation. Uterine rupture is fatal to the child in approximately six percent of cases, and the baby should be delivered within 40 minutes of the rupture.

Symptoms of a rupture may include the following:

  • Shock, decreased blood pressure or increased heart rate in the mother
  • Disproportionate vaginal bleeding
  • Slowed contractions or unusual pain between contractions
  • Protrusion below the pubic bone

Doctors may have difficulty diagnosing a rupture of the uterus without surgery. In the event of a rupture, the mother and child both face better outcomes if the baby is delivered surgically, which allows the doctors to provide necessary care for the infant, including oxygen. In the event of severe blood loss, the mother may need blood transfusion. In the most extreme cases, physicians may opt to stop the bleeding by removing the uterus.

According to Medscape, one of the predominant risk factors in uterine rupture is a uterine scar, which may result from a previous cesarean delivery or myomectomy. Other risks may include uterine trauma, congenital anomalies of the uterus and labor induction. An unscarred uterus is the least likely to rupture but is not a guarantee of safety.

Though uterine rupture can have terrible consequences, it fortunately is a rare occurrence. Incidence is the highest at two percent in mothers who have two or more cesarean scars. Among women who live in developed countries and have normal, unscarred uteri, the rate of rupture is as low as one in 8,434 pregnancies. 

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