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Uterine Rupture And Birth Injuries
Uterine rupture is a serious health complication a mother may experience during pregnancy that can threaten not only her life but the life of her baby as well. The unborn child is held by the uterus, which is actually a muscular organ, also referred to as the mother's womb. During labor, this organ contracts, forcing the baby through the birth canal during vaginal delivery.
Though many uterine ruptures are relatively mild in nature, and do not pose a serious health threat to the mother or baby, complications can occur, including brain damage to the baby and potentially death to the baby, mother or both. The condition of uterine rupture must be diagnosed and treated promptly by medical professionals in order to avoid these outcomes.
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Uterine Rupture Explained
Uterine rupture occurs when the uterine wall (through some or all of its tissue layers) experiences of separation, tear or rupture. The condition often coincides with fetal distress, excessive uterine bleeding, or protrusion or expulsion of the baby, placenta or both from the uterus — as such, the baby moves into the mother's abdominal cavity. The rupturing or tearing of the uterus can result in significant injury to the baby as he or she is deprived of either oxygen (hypoxia) or blood flow from the mother (ischemia). These conditions can lead to birth asphyxia, hypoxic ischemic encephalopathy and eventually cerebral palsy. When uterine rupture occurs, an urgent and immediate cesarean section delivery may be required to protect the life of the mother and infant.
Uterine Rupture Diagnosis
Unfortunately, prior to uterine rupture there is little to nothing medical personnel can do to predict or diagnose this occurrence. The mother may experience symptoms and warning signs of uterine rupture that are also similar to symptoms that accompany other obstetric issues. When uterine rupture is not diagnosed quickly due to mild initial symptoms, the dangers associated with it can increase because of the delayed medical response.
Indications that uterine rupture has occurred include:
- Abdominal pain — sudden pain in the abdomen
- Shock
- The baby's head receding back into the birth canal
- Weakening of contractions — the contractions of the uterus weakening may signal it is not functioning properly
- Excessive vaginal bleeding
- Rapid heart rate of the mother
- Abnormal infant heart rate — a slowed down or significantly reduced infant heart rate may indicate fetal distress and restricted flow of oxygen and blood to the baby
- Bulging below the pubic bone indicating the baby is protruding from the uterus
- Lowered blood pressure (maternal hypotension) and elevated heart rate (tachycardia)
Doctors usually diagnose uterine rupture based on the symptoms previously mentioned or through identification of uterine layer disruption through results of radiologic studies.
Physicians are extensively trained to identify the symptoms and warning signs of a potential hemorrhage or rupture of the uterus. If medical professionals fail in their responsibility to diagnose and respond appropriately to these warning signs and injuries occur as a result or become worse, a medical malpractice lawsuit may become a viable option for the victims. Establishing medical malpractice involves demonstrating that the injury you suffered was due to a violation by medical personnel of the expected standard of care.
Uterine Rupture Risk Factors
If a woman chooses to deliver a baby vaginally after she previously delivered through cesarean section, her uterine wall may be in a weakened condition from the C-section procedure and subsequently tear or rupture during the attempt at vaginal birth.
Attempting to augment or induce labor of an infant who is larger than normal for his or her gestational age can also increase the risk of vaginal tearing along the C-section scar line.
Additional risk factors for uterine rupture include:
- Inducing labor with Pitocin
- Inducing labor with Cytotec (misoprostol)
- Position of the unborn child not conducive to vaginal birth
- Abdomen trauma during pregnancy (i.e., car accident)
- 18 months or less between births
- Uterine manipulation
- Five or more previous pregnancies that reached 24 weeks minimum
Uterine Rupture Effect Upon The Infant
The infant is at risk for asphyxia (restricted oxygen supply) from the moment of uterine rupture to the time of delivery. If this occurs, the baby can suffer serious neurological damage and potential death. If an ultrasound reveals possible uterine rupture, it is imperative that the baby be delivered immediately by cesarean section. The infant will likely require resuscitation immediately after birth and additional care in a neonatal intensive care unit.
Uterine Rupture Effect Upon The Mother
Approximately 1 out of every 1,100 births involves uterine rupture. The mother can suffer severe blood loss and require a blood transfusion if her uterus ruptures or tears during pregnancy. Depending on certain factors involved with her injury and condition, the woman may have her uterus repaired or removed (hysterectomy).