During most pregnancies and the labor and delivery process, the uterus stays intact with no tearing. However, there are situations in which the uterus can sustain a tear or rupture. This can affect some or all of the layers of the uterus, compromising the oxygen supply that goes to the baby, as well as the health of the mother.
Uterine rupture frequently leads to severe bleeding, and the baby can move into the abdominal area of the mother when it’s time to deliver, further complicating the birth of the baby. Most cases of uterine rupture occur in women who have had C-sections with previous pregnancies that have left scarring on the uterus. The scars from those previous surgeries can tear, causing uterine rupture. Though uterine rupture is more likely in cases of a vaginal birth after cesarean section (VBAC), there are also situations in which the uterus tears even when it doesn’t have any scarring at all.
Diagnoses and Treatment of Uterine Rupture
Diagnosing a uterine rupture requires the expertise of a doctor who recognizes the signs and symptoms of the condition and is aware of the medical history of the expectant mother. The risk of uterine rupture is typically determined by reviewing an ultrasound, which will show scars from previous surgeries as well as the presence of a thin uterine wall. Abdominal pain, back and shoulder pain, and vaginal bleeding are all indicators of uterine rupture.
Uterine rupture is a medical emergency that requires immediate diagnosis and treatment. Because this type of tearing usually happens quickly, using extensive diagnostic testing may be too time-consuming to prevent irreversible damage from happening to the mother and the baby. It is often the case that the outcome of uterine ruptures depends on how quickly and appropriately doctors react to the situation.
The treatment for uterine rupture must be fast. Stabilizing the mother with fluid resuscitation and blood transfusion (when necessary) is essential, followed by the immediate delivery of the baby. To prevent serious complications from occurring, the baby must be delivered within a short amount of time from the rupture happening.
Following the delivery of the baby, the mother may need surgery to repair or remove (hysterectomy) the uterus, depending on the severity of the tear, the degree of bleeding, the general medical condition of the mother, and the mother’s desire for having more children in the future.
How Can Uterine Rupture Be Prevented?
Uterine rupture can be significantly harmful for both mother and baby – even resulting in death. So, any preventative measures that can be taken, should be. The most effective strategy for preventing uterine rupture is to minimize risk factors. This has to begin even before the first pregnancy.
The mother should:
- plan to become pregnant before the age of 30.
- not opt to have a C-section unless it’s absolutely necessary.
- avoid having an additional pregnancy within 2 years of a C-section.
- keep all doctor’s appointments, especially in the last trimester of pregnancy.
- always feel free to contact the doctor when there are any unusual feelings, such as sudden abdominal pain, decreased fetal movement, etc.
- meet with the doctor if the due date of the baby has passed.
The doctor should:
- identify whether the patient is at high risk of uterine rupture.
- utilize ultrasonography or MRI to obtain a clear picture of the uterus.
- inform and counsel the mother in detail about her condition and risks to help make the most informed medical decisions.
- make a timely decision regarding attempting a vaginal delivery versus opting for a C-section based on risk factors.
- monitor fetal heart rate and fetal activity.
- diagnose and treat any medical issues, including uterine rupture, promptly.
Uterine rupture can have severe consequences, but it is important to keep in mind that it is also very rare. When both mothers and doctors remain aware and alert, uterine rupture can be prevented or treated successfully.
When Uterine Rupture is Medical Malpractice
It’s important to remember that not all C-sections contribute directly to weak areas in the uterus. It is considered a risk factor, but it doesn’t mean that having a C-section is unsafe. When a vaginal birth isn’t possible, a C-section is a perfectly acceptable alternative.
Preventing a uterine rupture is possible when you are aware of your risk factors and have a doctor who properly ascertains those risk factors and gives proper advice on the pregnancy, labor, and delivery.
Unfortunately, even though the dire consequences of uterine rupture can often be avoided when there is a quick diagnosis and treatment, there are situations in which a doctor doesn’t identify the problem in a timely manner, doesn’t handle it properly, or makes a mistake during treatment. When that happens, it may be considered medical malpractice, and a birth injury case can be filed.
Birth injury cases are complicated, and they require the specific, extensive knowledge of both the law and medicine. At Ross Feller Casey, we have a team of leading doctors and doctor-lawyers right on staff to help in these types of cases. Our team has an unmatched record of winning multi-million-dollar birth injury cases, including those involving uterine rupture.
If you or a loved one has suffered a uterine rupture that may have been prevented, contact the birth injury experts at Ross Feller Casey for a free case evaluation.