• Occurs when a uterus undergoes more strain than it is capable of sustaining.

• Occur most commonly when a vertical scar from a previous CS or hysterectomy repair tears.

• Confirmed by Ultrasound

• An immediate emergency situation

Predisposing factors

1. Prolonged labor

2. Abnormal presentation

3. Multiple gestation

4. Unwise use of oxytocin

5. Obstructed labor

6. Traumatic maneuvers of forceps or tractions

 If uterine rupture occurs fetal death will follow UNLESS immediate CS is done.

 Impending rupture may be preceded by a pathologic retraction ring and by strong uterine
contractions without cervical dilatation.

 TO PREVENT RUPTURE: anticipate the need of an immediate CS

Assessment

1. Sudden, severe pain during a strong labor contractions

2. Tearing sensation

Types

1. Complete rupture

 endometrium, myometrium and peritoneum layers

 uterine contractions will immediately stops

 2 distinct swellings will be visible on the woman’s abdomen

a) The retracted uterus

b) Extrauterine fetus

 Signs of shock: rapid weak pulse, falling BP, cold clammy skin, dilatation of the nostrils, FHR
fades and then are absent.

2. Incomplete rupture

 leaving the peritoneum intact

 the signs of rupture are less evident

 woman experience only a localized tenderness and a persistent aching pain over the area of the
lower uterine segment

 fetal and maternal distress

 lack of contractions

Nursing care management

1. Administer emergency fluid replacement therapy as ordered.

2. Anticipate the use of oxytocin to attempt to contract the uterus and minimize bleeding

3. Prepare the woman for possible laparotomy as an emergency measure to control bleeding and
achieve a repair

4. Advised not to conceive again after a rupture of the uterus---unless the rupture occurred in the
inactive lower segment.

5. Perform a ceasarian hysterectomy (with consent) fear of the removal of the damaged uterus or
tubal ligation at the time of laparotomy ==== result in the loss of childbearing ability.