UTERINE RUPTURE
Uterine
rupture can be said to have occurred when there is a total disruption of
uterine wall with or without the extrusion of the baby or the placenta. It is
usually accompanied by bleeding into the peritoneal (abdominal) cavity. The
extent of blood loss depends on the part of the uterus and the vessels that
were disrupted. It is a monumental disaster that can kill the baby or the
mother due to ignorance of the grave danger unskilled childbirth practice pose.
Cessation of
uterine contractions can be the first signal of uterine rupture. A woman shouting from time to time from the
pains of strong uterine contractions suddenly feels relief from such
contractions. However, such relief is temporary as she is greeted by constant
abdominal pain. She can also feel like fainting.
Some women
notice vaginal bleeding following uterine rupture. Many may not see any blood
in their private parts because a deeply impacted fetal presenting part has
effectively walled off the blood in the peritoneal cavity from egress to the
vagina.
The doctor can notice that it is easy to palpate fetal parts
in a woman whose uterus has ruptured especially when the baby was forcefully
extruded from the uterine cavity. The womb can be found contracted down in the
abdominal cavity. In such cases the peritoneal covering of the womb (the
serosa), the muscle layer, the decidua (inner layer) and the fetal membranes
(amnion and chorion) are all disrupted.
Blood can be found in the urine
following uterine rupture. This is evidence of the disruption (rupture) of the
urinary bladder. However, in obstructed labour, blood can also be found in the
urine without uterine rupture because of compression of the bladder by an
impacted fetal presenting part. There is interruption of blood flow from the
bladder. Some blood vessels can break and release blood into the urine. Outflow
of urine is also interrupted and bladder can become swollen from retained urine
or oedema
Epigastric pain accompanied by respiratory embarrassment can
occur following uterine rupture. It can be due to extrusion of the baby or placenta
into the epigastric area (area over the stomach or gaster). The baby impinges
on the diaphragm restricting respiratory movements. Blood, liquor or urine that
piled up in the paracolic gutters can also flow to the diaphragm restricting
respiratory movements
