During the process of giving birth to your child, especially when the placenta comes out, there are some possible risks, such as rupture of the uterine wall. Often, this is related to the time of a previous caesarean section, known as uterine rupture or vaginal labia rupture. It includes the complete tearing of all layers of the uterine wall, and it can cause serious consequences for both the mother and the fetus. In this Dalili Medical, , the causes of rupture of the uterine wall and the available treatment methods are discussed.
Are we tearing the womb?

 

Rupture of the uterus is a condition that occurs when the muscular wall of the uterus separates during pregnancy or childbirth. This separation can lead to expulsion of the fetus and placenta into the abdominal cavity, which may cause serious injuries to the mother and the fetus, and may even lead to death. Often, uterine rupture is associated with a previous caesarean section or other injuries in the uterus, which may weaken the uterine wall.

Is it possible to get pregnant after uterine rupture?

 

Yes, it is possible to get pregnant after uterine rupture, also known as uterine rupture. However, the ability to carry and continue until the end of the height is affected by other factors related to the severity of the tear and the healing period that follows. If a tear has occurred in the past, the extent of the tear and the resulting damage will play an important role in determining the results of fertility and pregnancy.

Are we the types of uterine rupture?

 

1- **Complete uterine rupture**: It includes the rupture of all the muscular layers of the uterus, which leads to the leakage of the contents of the pregnancy into the abdominal cavity. And in the case of an intervening condition, the height remains the first part of the fetus inside the uterus, while the second part is in the abdomen.

2- **Imperfect rupture of the womb**: does not include all classes, where the al-Ghasha al-Britoni remains intact.

Is there a way to prevent uterine rupture?

 

There is no effective way to prevent uterine rupture by resorting to caesarean section, especially if the woman has undergone previous caesarean section, as natural childbirth after caesarean section increases the risk of uterine rupture.

What are the factors that increase the risk of uterine rupture?

 

1- The existence of a previous history of cesarean delivery, as this is considered the most important factor, and the risk increases with the increase in the number of previous cesarean operations.

2- The presence of birth defects in the womb, such as Zul-Qarnain womb or Al-Hijab-ur-Rahmi.

3- Performing previous surgeries on the uterus.

4- Injuring the womb due to injuries or bruises.

5- There are records of uterine rupture.

Am I the most vulnerable to uterine rupture?

 

Women who have undergone caesarean section or any previous surgery in the uterus are exposed to increased risk, due to the presence of scars that weaken and lead to rupture. However, some types of uterine scars are more prone to rupture during vaginal labor than others. The women who are most at risk of uterine rupture are those who have had a natural birth after a cesarean section in a previous pregnancy.
Types of uterine rupture:

**tearing the full womb**

Complete uterine rupture occurs when the rupture extends through all layers of the uterine wall, including the uterine muscle and mucous membrane. This type of rupture is considered the most dangerous, as it can lead to serious complications such as bleeding and fetal health problems.

**Incomplete uterine rupture**

Incomplete rupture of the uterus, also known as rupture of the uterus, refers to a tear that does not extend completely through the uterine wall. Although this type is less serious than full tear, it still represents a great danger and requires immediate medical attention.
What are the symptoms?

 

The symptoms of uterine rupture vary according to the time of occurrence before labor or during labor, so if it occurs before labor, it often occurs in the previous uterine scar, and the woman's pain from mild to moderate pain gradually increases to severe symptoms, especially when accompanied by trauma. If uterine rupture occurs during labor, the symptoms develop acutely, including: [4]

- Ziadea al-Fawliyyah al-Rahmia, which increases in height to the point of spasm of the uterus.

- Sudden pain is similar to the taunt of a dagger.

- Uterine contractions become severe and then stop suddenly.

- Stopping the movements of the fetus.

- The occurrence of severe intra-abdominal bleeding, and the appearance of signs of hemorrhagic shock (decreased arterial tension, rapid heart rate, profuse sweating).

### Causes of uterine rupture

There are several factors that increase the risk of uterine rupture, the most important of which are:

#### History of previous uterine surgery
The history of uterine surgery, especially cesarean delivery, is considered one of the most important risk factors for uterine rupture. The scar resulting from the previous surgeries weakens the wall of the uterus, which makes it more prone to rupture during pregnancy or subsequent birth.

#### number of pregnancies
Women who experience multiple pregnancies (high number of births) are exposed to the greatest risk of tearing the womb. Repeated stretching and contraction of the uterus leads to weakness over time.

#### Stimulation of labor
The use of drugs that prevent or accelerate the birth process, such as oxytocin or prostaglandin, increases the risk of uterine rupture. These drugs can cause strong and frequent contractions, which puts excessive pressure on the uterine wall, especially if there is a scar.

#### Injuries
Injuries to the abdominal area, such as car accidents or falls, can also lead to uterine rupture. The force resulting from the trauma may lead to rupture of the uterine wall, especially if there are other factors that weaken the uterus.

#### Congenital abnormalities of the uterus

Certain congenital abnormalities in the uterus, such as the zul-qarnain uterus or the divided uterus, are factors that increase the risk of uterine rupture. These structural abnormalities can lead to areas of weakness in the uterine wall, making it more susceptible to rupture during pregnancy or childbirth.

**Diagnosis of uterine rupture**

Early diagnosis of uterine rupture is vital for managing the condition and reducing potential risks. Diagnosis usually includes the following:

**Medical examination in the clinic**

Comprehensive clinical examination, including pelvic examination, to detect signs of uterine rupture. The health care provider should evaluate the pain in the abdomen, the abnormal position of the fetus, in addition to the symptomsRaz Al-Altar Al-Taght indicates the occurrence of tearing.

**Ultrasound examination**

Ultrasound can be used to image the uterus and identify any torn areas. This technique also helps in evaluating the condition of the fetus and the amount of amniotic fluid available.

** Fetal monitoring **

Continuous monitoring of the fetus is considered necessary to detect signs of distress, such as abnormal patterns in the heart rate, which may indicate uterine rupture.
Are there medical conditions other than pregnancy that can lead to tearing of the uterine muscles?

 

Usually, the rupture of the uterine muscles is associated with pregnancy and childbirth, as a result of the stretching and contractions of the uterus during these periods. However, there are some rare medical conditions that may lead to rupture of the uterine muscles even in the absence of pregnancy. These cases are not common and often require the presence of certain factors.

Here are some examples:

**Fibrous tumors of the uterus:**
Fibroid tumors are non-cancerous tumors that form inside the uterine wall. Although most of these tumors do not lead to uterine rupture, in some cases, especially when they are very large or cause significant deformation in the uterine wall, the height contributes to the weakening of the uterine muscle.

**Injuries in the abdominal area:**
Severe injuries in the abdominal area, such as accidents or injuries, can lead to uterine rupture. However, this situation is very rare and often requires great strength.

**Surgical procedures:**

Surgical interventions involving the uterus, such as removal of fibroids or some fertility enhancement procedures, can lead to the weakening of the uterine wall.

**Al-Tarikh al-Jarhari for Mercy:**

If the woman has undergone previous surgeries related to the uterus, such as cesarean delivery or surgery to treat other medical conditions, there may be a slight increase in the risk of uterine muscle explosion in non-pregnant situations. It is possible that the scar tissue resulting from the previous operations will lead to the weakness of the uterine wall.

Connective tissue disorders:

Some rare connective tissue disorders, such as Ehlers-Danlos syndrome, can lead to tissue weakness in the body, including the uterus. However, these cases are extremely rare.

**Inflammation or infection:**

Severe infection or inflammation affecting the tissues of the uterus can lead to weakness over time. Although these cases are not common, they theoretically contribute to the explosion of the uterus.

What are the complications of uterine rupture?

 

1- Fetal death: Research shows different rates of fetal death, where in some studies it reached more than 50% in cases of complete uterine rupture. However, most studies have shown an increase in the percentage of fetal deaths in the following cases:

- Extraction of embryos after 30 minutes of complete uterine rupture.

- Detachment of the placenta.

- The exit of the fetus from the uterus to the abdominal cavity.

2- Lack of oxygen in the fetus, intraventricular bleeding, and brain perfusion deficiency.

3- My mother's suffering from complications such as heavy bleeding and hemorrhagic trauma, uterine rupture, the need for blood transfusion, and injuries in the urinary system.

In general, the occurrence of complications depends on the size of the rupture and the location and speed of the surgical intervention, and these complications are more severe in the case of rupture in a healthy uterus.

**How ​​long does it take to heal my rupture of the womb?**

 

The mother needs a period ranging from four to six weeks to recover, and during this period it is preferable to adhere to the following:

- Rest and following a healthy diet.
- Avoid carrying heavy weights.
- Abstaining from exercising and climbing stairs.
- Avoid bathing in the bathtub.
- Abstaining from sexual intercourse.

**The cause of my rupture of the womb**

Although it is not possible to avoid all cases of uterine rupture, there are some measures that can help reduce the risk:

**Credits for vaginal birth after caesarean section (VBAC)**

Women who have undergone a previous caesarean section and are considering a vaginal birth after a caesarean section (VBAC) should discuss the risks and benefits with their healthcare provider. Careful monitoring and appropriate management during labor can contribute to reducing the risk of uterine rupture in these cases.

**Avoid unnecessary incitement**

You must be careful when using drugs to stimulate or increase the volume of the uterus, and they must be used only when medically necessary.

**Careful monitoring during the birth process**

The importance of careful monitoring of the mother and the fetus during labor is vital for early detection of any signs of uterine rupture. The continuous monitoring of the condition of the fetus and the regular evaluation of the condition of the mother contribute to the immediate identification of any complications that may occur.

**Treatment of uterine rupture**

Usually, the treatment of uterine rupture requires urgent surgical intervention. The main purpose of treatment is to control the bleeding, repair the tear, and ensure the safety of the mother and the fetus.

**emergency caesarean section**

In cases of uterine rupture, an emergency caesarean section is usually performed to remove the child and avoid additional complications. The surgical team works quickly to stabilize the mother's condition and treat any bleeding that may occur.

**Removal of the uterus or removal of the uterus**

Depending on the severity of the rupture and the extent of the damage to the uterus, the surgeon may try to repair the rupture. In some cases, hysterectomy may be necessary to control the bleeding and prevent other complications.

**My blood**

Loss of large amounts of blood is one of the common complications of uterine rupture, and blood transfusion is required to replace the loss and stabilize the condition of the mother.