rupture of uterus in pregnancy

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Uterine rupture in pregnancy is a rare and often catastrophic complication with a high incidence of fetal and maternal morbidity.

Introduction

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Definition

Uterine scar dehiscence constitutes separation of a preexisting scar that does not disrupt the overlying visceral peritoneum (uterine serosa) and that does not significantly bleed from its edges.

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In contrast to the availability of models to predict the potential success of a TOL after a prior cesarean section, accurate models to predict the person-specific risk of uterine rupture for individuals are not available.

Incidence and risk factors

Scarred status may include previous cesarean delivery, including the following:

– Classic vertical – Single low transverse (further subcategorized by 1-layer or 2-layer hysterectomy closure) – Single low vertical – Multiple previous cesarean deliveries

Pregnancy considerations include the following

– Grand multiparity – Cornual (or angular) pregnancy – Maternal age – Placentation (accreta, percreta, increta, previa, abruption)

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– Previous successful vaginal delivery – No previous vaginal delivery – Inter-delivery interval

Previous pregnancy and delivery history may include the following:

Maternal age

Increasing maternal age has a detrimental effect on the rate of uterine rupture. The rate of uterine rupture in women differed significantly.

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