Uterine rupture, complications during childbirth due to uterine rupture

All mothers dream of a smooth delivery process accompanied by the birth of a healthy baby. But sometimes, giving birth to a healthy baby can not be accompanied by a smooth delivery because of complications in childbirth. One that may occur is uterine rupture (uterine rupture). The definition of uterine rupture is the uterus that is torn during childbirth.

Not only is it dangerous for the mother, uterine rupture during childbirth can also threaten the health of the baby. In order to prevent the risk, see the full review of the following uterine rupture.

What is uterine rupture?

The definition of a uterine tear or what in medical terms is called uterine rupture is a condition that occurs when there is a tear in the uterine wall.

As the name implies, uterine rupture is a condition that can tear the entire lining of the uterine wall, endangering the health of the mother and the baby.

Do not rule out, uterine rupture can result in heavy bleeding in the mother and baby who are stuck in the womb.

Even so, the risk of uterine rupture or uterine rupture during labor is very small.

This figure ranges from less than 1 percent or only 1 in 3 women who are at risk of experiencing uterine rupture during childbirth.

These complications of uterine rupture delivery usually occur during normal delivery or vaginally in any labor position.

The risk also increases for those of you who undergo normal delivery after cesarean section (VBAC).

Yes, vaginal birth after caesarean (VBAC) or what is known as a normal delivery after cesarean section can increase the risk of the mother experiencing uterine rupture.

The chance of a uterine tear can increase each time you have a cesarean delivery and then move on to a normal delivery.

That is why doctors are generally more likely to advise pregnant women to avoid vaginal delivery if they have previously had a cesarean section.

However, that does not mean there is absolutely no chance for pregnant women to give birth normally after having had a previous cesarean section.

It's just that, not all conditions for a woman's body allow her to have a normal delivery if she has previously given birth by caesarean section.

It is the doctor who will consider and determine the best choice of delivery method according to your health condition and the baby in the womb.

It is important to understand that uterine rupture is a very rare complication of childbirth.

Especially if you have never given birth by caesarean section before, underwent surgery on the uterus, or have a torn uterus.

The risk of experiencing uterine rupture during normal delivery is of course very small.

Although most uterine ruptures usually occur during labor, they can also develop before delivery.

What are the symptoms of uterine rupture during childbirth?

Uterine rupture or tear of the uterus is a complication that usually starts in early labor.

Furthermore, these tears can further develop as normal labor progresses.

The doctor may notice the early symptoms of uterine rupture because of an abnormality in the heart rate of the baby in the womb.

Not only that, the mother will also experience symptoms in the form of severe abdominal pain, vaginal bleeding, to pain in the chest.

You may feel chest pain due to irritation of the diaphragm due to internal bleeding in the body.

On this basis, the condition of pregnant women and their babies undergoing normal delivery after having previously had a cesarean section needs to be continued to be considered.

The monitoring, which is carried out by the doctor and the medical team, aims to detect any dangerous complications.

That way, medical action can be done as quickly as possible.

Overall, the symptoms when the mother experiences uterine rupture or uterine rupture during labor are as follows:

• Bleeding from the vagina in excessive amounts
• There is intense pain between contractions during normal delivery
• The strength of labor contractions tends to be slowed down, weakened and less intense
• Abdominal pain or pain that is not uncommon
• The baby's head stops in the birth canal when it is removed through the vagina
• There is sudden pain in the previous caesarean section incision in the uterus
• The strength of the muscles in the uterus disappears
• Mother's heart rate changes to become faster
• Low maternal blood pressure
• Abnormal baby's heart rate
• Normal delivery is not progressing

You should immediately consult a doctor if the mother experiences various symptoms that lead to uterine rupture plus various signs of childbirth appear.

Apart from the original contractions, signs of labor also include the opening of the delivery and the rupture of the amniotic fluid.

Mothers with this condition are strongly advised to give birth in the hospital and not give birth at home.

Because the birth process can come at any time, make sure the mother has prepared various preparations for childbirth and delivery supplies from long ago.

If the mother has a doula, this childbirth companion generally continues to accompany the mother from pregnancy to completion of labor.

What causes uterine rupture during childbirth?

Most cases of uterine rupture during labor occur right in the area of ​​the wound from the previous cesarean section.

Then when undergoing a normal delivery, the movement of the baby will put a strong pressure on the uterus.

The pressure caused by moving the baby is so strong that it can affect the caesarean section scar.

This is what causes uterine rupture because the uterus seems to be holding back the weight and pressure of the baby's movements.

This tear in the uterus is usually very visible in the area of ​​the scar during the previous cesarean section.

When uterine rupture occurs, the baby in the womb can move up and lead back to the mother's stomach.

Yes, instead of leaving the uterus, all the contents of the uterus, including the baby, will actually enter the mother's stomach.

The condition of the uterus torn most at risk occurs in mothers who have a vertical incision as a caesarean section in the upper part of the uterus.

Also, if you have had various types of surgery on the uterus before, this could be a cause of uterine rupture.

Surgical removal of benign tumors or fibroids in the uterus and repairing the problematic uterus could be one of the causes.

Meanwhile, the possibility of a uterine tear even though the condition is classified as healthy is very rare.

The condition of a healthy uterus here means that you have never given birth before, never underwent surgery on the uterus, or have given birth but with normal methods.

However, even though the condition of the mother's uterus is healthy, it is still possible for this one birth complication to occur.

This depends on the risk factors that the mother has.

What factors increase the risk of uterine rupture?

A number of risk factors that can increase the chances of uterine rupture during childbirth even though the uterus is healthy, such as:

• Have given birth 5 or more times
• The position of the placenta is too deep in the uterine wall
• Contractions that are too frequent and strong either due to the influence of the administration of drugs such as oxytocin and prostaglandins, or the release of the placenta from the uterine wall (placental abruption)
• The delivery process takes a long time because the baby is too big compared to the size of the mother's pelvis

In addition, there are other risk factors for uterine rupture, including:

• Never had a caesarean section before
• Have ever given birth normally or vaginally
• Perform labor induction
• Baby size is too big

Again, having had a previous cesarean section and undergoing a normal delivery method at a later birth puts you at a higher risk of having a uterine rupture.

In fact, giving birth using the normal method beforehand also puts you at a risk of experiencing a uterine rupture.

It's just that, launching from the South Australian Perinatal Practice Guideline, the chances of this condition being different are different for normal and caesarean delivery methods.

The likelihood of uterine rupture is likely to be greater if you have had a previous cesarean delivery and had a normal delivery afterward.

Meanwhile, in normal delivery in the first and second pregnancies, the chances of uterine rupture are much smaller.

The condition of the uterus is too distended or large can also be a risk factor for uterine rupture or uterine rupture.

Changes in the shape of the uterus usually occur due to the influence of too much amniotic fluid or having been pregnant with twins, triplets, or more.

Have had a car accident that affected the uterus or underwent action external cephalic version may be a risk factor for uterine rupture.

External cephalic version is a procedure to change the position of a breech baby during delivery.

What are the complications of uterine rupture?

The possibility of uterine rupture during childbirth is actually very rare.

Complications that may arise because the uterus is torn during childbirth can be fatal to both the mother and the baby in the womb.

For the mother, for example, it can cause large amounts of bleeding. Meanwhile, in infants, uterine rupture can cause much bigger health problems.

After finding a uterine rupture during delivery, doctors and the medical team will immediately act quickly to remove the baby from the mother's womb.

This is because if it is not immediately issued within about 10-40 minutes, this can be fatal to the baby.

Most likely the baby will die from lack of oxygen in the womb.

That is why, before delivery the doctor will usually determine the right method of delivery according to your health condition and the baby.

If you do have risk factors that increase the chances of uterine rupture, doctors and the medical team usually advise against vaginal delivery.

However, if for one reason or another the doctor allows you to take the normal delivery method, monitoring will always be carried out during labor.

How to diagnose uterine rupture?

The presence of uterine rupture is usually only diagnosed during delivery.

This is because the symptoms of new uterine rupture can easily be seen when the labor process is in progress.

Meanwhile, before labor begins, a tear in the uterus tends to be difficult to detect because the symptoms are not very specific.

The doctor can suspect uterine rupture during labor.

To ensure this, doctors will usually look for symptoms of uterine rupture in both mother and baby.

These symptoms include a slowing of the baby's heart rate, a drop in maternal blood pressure, large amounts of vaginal bleeding, and so on.

In essence, the diagnosis of a torn uterus can only be made by a doctor during labor.

Because, this is where the symptoms of a torn uterus are more easily seen than before delivery.

How to treat uterine rupture during childbirth?

If the doctor sees your uterus torn while a normal delivery is in progress, a caesarean section will be performed immediately.

That means, the normal vaginal delivery process cannot continue, and is replaced with a cesarean delivery.

Delivering by caesarean section aims to prevent fatal risks to both mother and baby.

This method can pull the baby out of the mother's womb so that his chances of survival can be greater.

The doctor will then provide further care for the baby such as giving additional oxygen.

In other cases, if the uterus is torn or the uterine ruptures causing profuse bleeding, the doctor may undergo a hysterectomy procedure.

A hysterectomy is a medical procedure to remove the uterus from the female reproductive system.

Not only by doctors, the decision to do this hysterectomy must also be carefully considered by you.

The reason is, after undergoing surgery to remove the uterus, you will automatically no longer be able to get pregnant.

In fact, the menstruation that you should regularly experience every month will also stop. Your doctor can also give you a blood transfusion to replace the blood that is lost from your body.

Are all mothers undergoing VBAC at risk of uterine rupture?

As mentioned earlier, a normal delivery after a cesarean section is a condition that is likely to result in uterine rupture.

Even so, not all cases of normal delivery after cesarean delivery (VBAC) can always cause uterine rupture.

There are conditions that a cesarean section is still allowed by doctors to give birth normally in subsequent pregnancies.

This usually occurs if the caesarean section you have is a horizontal line, which is located low below the abdomen.

Explained by American College of Obstetricians and Gynecologits (ACOG), in the American Pregnancy Association.

If you have a history of caesarean section with a horizontal incision in the lower abdomen and want to have a normal delivery to your next child, there are risks involved.

In this case, the risk of uterine rupture is 0.2% -1.5% or equal to 1 per 500 deliveries.

Meanwhile, doctors do not recommend that you do VBAC if the cesarean section is a vertical line.

Unlike the horizontal incision, this vertical incision is located at the top of the uterus and abdomen.

This vertical or 'classic' incision with the letter T is the most at risk for uterine rupture.

A tear in the uterus with a vertical incision can easily occur when you are pushing to expel the baby during a normal delivery.

Therefore, usually the doctor will examine the condition of you and your baby. first.

If it is not possible to give birth normally after cesarean section (VBAC), further delivery will still be done by caesarean section again.

However, if the doctor allows you to do VBAC, the doctor and medical team will always monitor the condition of you and the baby during labor.

Is there a way to prevent uterine rupture during childbirth?

The only way to prevent uterine rupture is to have a caesarean section to give birth.

This method will usually be recommended by the doctor before entering labor, taking into account the condition of you and your baby.

It would be a good idea to routinely check the womb, and consult all plans related to later delivery with your doctor.

Also make sure the doctor knows all medical history, along with a history of previous pregnancy and childbirth.

That way, the doctor can determine the best decision for you and your baby according to the conditions experienced.

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