Uterine rupture
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Uterine rupture
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Uterine rupture is a rare complication of pregnancy usually occurring along healed scar lines in the uterus in women who have had prior cesarean deliveries. It usually occurs in late pregnancy or during active labor.
Anesthetic implications
Preoperative optimization
In patients attempting a trial of labor after C-section (TOLAC), particular attention must be paid to the risk of uterine rupture, especially as it may present differently with or without an epidural in place.
Intraoperative management
Postoperative management
Related surgical procedures
Pathophysiology
Causes of uterine rupture include uterine overdistension (multiparity, polyhydramnios, fetal anomalies), external or internal fetal version, iatrogenic perforation, excessive use of uterotonics, or failure to recognize labor dystocia.