What is the most typical manifestation of uterine rupture?

summary

Some people say that women are really happy when they are pregnant, and they will be cared for wherever they go. Expectant mothers seem to be very happy, but in fact there are still some dangers. Uterine rupture is one of them. Most of these diseases occur during pregnancy or childbirth, which is a great threat to patients. Next, let's look at the most typical manifestation of uterine rupture!

What is the most typical manifestation of uterine rupture?

Bleeding uterine rupture is usually characterized by massive bleeding, which can be divided into internal bleeding, external bleeding or mixed bleeding. Internal hemorrhage refers to the accumulation of blood in the broad ligament or abdominal cavity, resulting in broad ligament hematoma or hemoperitoneum. External bleeding refers to the discharge of bleeding from the vagina. The bleeding sites of uterine rupture usually include uterine and soft birth canal rupture and placental exfoliation bleeding. Uterine and soft birth canal bleeding usually needs to damage the large blood vessels of the location. If the soft birth canal injury does not damage the large blood vessels, it usually does not show massive bleeding or active bleeding. The bleeding of placental exfoliation surface is related to the degree of placental exfoliation and the intensity of uterine contraction. If the placenta is not completely exfoliated or not discharged from the uterine cavity after exfoliation, the uterine contraction will be affected, which is characterized by massive bleeding.

The main sites of infection after uterine rupture are pelvic cavity, abdominal cavity, pelvic retroperitoneum and soft birth canal. The main causes of infection are that the pelvic cavity or broad ligament is connected with the uterine cavity and vagina, and bacteria enter after communication; Bleeding after uterine rupture, severe anemia or DIC, decreased resistance, easy to infection; Hematocele in abdominal cavity or pelvic cavity or extraperitoneal hematocele is easy to be infected; After uterine rupture, hysterectomy or repair were carried out under the condition of bacteria. In addition, it is worth mentioning that the infection is respiratory tract infection, which is caused by many factors, such as long shock time, impaired expectoration and defense mechanism of normal respiratory tract.

Incomplete uterine rupture: refers to the rupture of all or part of the myometrium, the serous layer has not yet been penetrated, the uterine cavity is not communicated with the abdominal cavity, and the fetus and its appendages are still in the uterine cavity. Abdominal examination showed tenderness at the incomplete rupture of the uterus. If the rupture occurred between the two lobes of the broad ligament in the lateral wall of the uterus, a hematoma in the broad ligament could be formed. At this time, a gradually enlarged and tender mass could be touched on one side of the uterine body. Fetal heart sounds are irregular. If the uterine artery is torn, it can cause severe extraperitoneal hemorrhage and shock. Abdominal examination of the uterus still maintain the original shape, obvious tenderness after rupture, and gradually increased hematoma can be touched on one side of the abdomen. Broad ligament hematoma can also be extended upward to become retroperitoneal hematoma. If the bleeding continues, the hematoma can penetrate the serous layer and form complete uterine rupture.

matters needing attention

Strengthen the publicity and implementation of family planning to reduce the number of pregnant women; We should change the concept of delivery, advocate natural delivery and reduce the rate of cesarean section; Those who have the history of dystocia or cesarean section should be hospitalized early, closely observe the progress of labor, and decide the mode of delivery according to the obstetric indications and previous operation. The indications, usage and dosage of oxytocin should be strictly controlled, and a special person should be assigned to guard it; For the pregnant women with uterine scar and uterine deformity, the labor process should be closely observed and the indications of cesarean section should be relaxed; Close observation of the labor process, for the first exposure height, abnormal fetal position of pregnant women should be carefully observed; Avoid damaging vaginal midwifery and operation, such as mid high forceps, midwifery before uterine orifice is fully opened, internal inversion for neglected shoulder presentation, forced extraction for placenta accreta, etc.