Uterine rupture is a serious pre-delivery emergency that can occur in mothers during pregnancy. Although it is not common, it is life-threatening and requires the fastest possible assistance to reduce the risk of death for both the mother and the baby in the womb.
What is uterine rupture?
Uterine rupture is a severe medical emergency caused by a rupture of the uterus. The uterine wall tears, and the tissues split and separate during pregnancy or labor, leading to severe bleeding, with blood flowing into the abdominal cavity. The baby and amniotic fluid may be expelled from the uterus into the abdominal cavity, resulting in fetal death in utero. If the uterus tears through the full thickness of the uterine wall, immediate treatment is required because it is extremely severe and can be fatal for both the mother and the fetus.
What causes uterine rupture?
- A history of uterine scarring from a cesarean section, surgery to remove uterine fibroids, uterine abnormalities, etc.
- Abnormal fetal position or cephalopelvic disproportion during labor, twin pregnancy, prolonged labor, difficult labor, use of medications to stimulate uterine contractions
- Pregnant mothers who deliver vaginally after a prior cesarean delivery
- Weak uterine muscles or an abnormally thin uterine wall
- A history of severe trauma, uterine impact, or uterine injury
***The risk of uterine rupture increases with each subsequent cesarean delivery.
What are the symptoms of uterine rupture?
- Sudden, severe abdominal pain
- Pain above the pubic bone
- Tenderness when pressing on the abdomen
- Vaginal bleeding (but it may be absent if bleeding is into the abdominal cavity)
- Abnormal fetal heart rate; decreased fetal movement or no movement
- Severe hemorrhage with faintness, palpitations, dizziness, low blood pressure, collapse, loss of consciousness, progressing to shock
Diagnosis of uterine rupture
- Clinical assessment of symptoms
- Uterine ultrasound examination
- Fetal heart rate monitoring
Treatment and care for uterine rupture
- Multidisciplinary Team (Multidisciplinary Team): As soon as the event occurs, the emergency medical team performs a detailed assessment and provides urgent life-saving care, while calling in the obstetrics–gynecology team, anesthesiologists, neonatologists (Neonatologist) and specialized professional nurses, who assemble in the operating room within minutes to perform an emergency abdominal cesarean delivery as quickly as possible. Depending on severity, uterine repair or hysterectomy may be required.
- Operating room and equipment ready immediately: We have operating rooms that can accommodate emergency cases immediately, along with a blood bank system that continuously stocks necessary blood and blood components.
- Critical newborn care (NICU): If preterm delivery is required or the baby has oxygen deprivation the NICU medical team at Level 4 is ready to care for the baby with the most advanced life-support technology.
How can uterine rupture be prevented?
Uterine rupture is an unexpected emergency for mothers in high-risk groups. The key is antenatal care with an experienced obstetrician-gynecologist and at a hospital equipped with modern tools and an experienced multidisciplinary team, and it is most important to inform the doctor of your surgical history in detail. Monitor symptoms closely; if any abnormalities occur during pregnancy, see a doctor immediately. The doctor will assess the thickness of the uterine wall via ultrasound, helping to improve diagnostic clarity. With the experience of our medical team, we can evaluate warning signs and plan a smooth delivery, such as deciding on an emergency cesarean section (Emergency C-Section) or scheduling a cesarean delivery before labor begins, to reduce risks to the lives of both mother and baby.
How dangerous is uterine rupture?
Uterine rupture is uncommon, but it can occur and is life-threatening. It most often occurs in pregnant mothers who have had uterine surgery, uterine wall surgery, or a cesarean section, as well as those with difficult childbirth. If the rupture is severe with major blood loss, mothers often deliver prematurely and it may be severe enough to result in death.
Hospital specialized in caring for uterine rupture
Women’s Health Center Bangkok Hospital is ready to provide comprehensive pregnancy care from the first day of pregnancy. If uterine rupture is found, our specialist physicians and multidisciplinary team are ready to provide close treatment, care, and consultation with expertise around the clock 24 hours a day.
Specialist physicians in maternal-fetal medicine
- Dr. Teera Wacharaprechanont
- Dr. Romsai Lerdpienpitayakul
- Dr. Weerawich Pornwattanakrilert
- Asst. Prof. Dr. Adjima Soongsatitanon
Maternal-Fetal Medicine Specialist, Women’s Health Center, Bangkok Hospital
