Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be

talking to you about uterine rupture. And you can find written notes on this topic at

zero to finals.com slash uterine rupture or in the labor and delivery section of the Finals Obstetrics and Gynaecology book.

So let's get straight into it.

Uterine rupture is a complication of labour where the muscle layer of the uterus, the myometrium,

ruptures.

With an incomplete rupture, which is called uterine dehiscence,

the uterine serosa, which is the perimetrium that surrounds the uterus, remains intact.

With a complete rupture, the serosa ruptures along with the myometrium and the contents of the uterus are released into the peritone cavity.

Uterine rupture leads to significant bleeding.

The baby may be released from the uterus into the peritoneal cavity.

A uterine rupture has a high morbidity and mortality for both the baby and the mother. Let's go through the risk factors. The main risk factor for

uterine rupture is a previous caesarian section. The scar on the uterus becomes a point of weakness and may rupture

with excessive pressure, for example with excessive stimulation by oxytocin. It's extremely rare for a

uterine rupture to occur in a patient that's giving birth for the first time. The risk factors to consider

are a vaginal birth after caesarean or V-back, previous uterine surgery, increased BMI,

meaning obesity, high parity, meaning many previous deliveries, increased age, induction of labour and the use of

oxytocin to stimulate contractions.

Let's go through the presentation.

Uterine rupture presents with an acutely unwell mother and an abnormal CTG.

It may occur with induction or augmentation of labour with stimulation of uterine

contractions using oxytocin, with signs and symptoms of abdominal pain, vaginal bleeding,

...