Causes of uterine rupture

Uterine rupture is a condition that many women often encounter during pregnancy. Generally, pregnant women with uterine rupture are in great danger. Uterine rupture can cause great harm to the body of pregnant women, so most people do not want to see uterine rupture happen. In addition, there are many reasons that may cause a pregnant woman to suffer from uterine rupture. Therefore, only by understanding the causes of uterine rupture can we fundamentally prevent the occurrence of uterine rupture.

Everyone should know that the uterus is very important to women. The uterus is the prerequisite for a woman to become pregnant. Without a uterus, a woman cannot become pregnant and cannot become a complete woman. However, uterine rupture can cause severe damage to the uterus. So, let’s talk about the causes of uterine rupture.

Uterine rupture refers to a laceration of the uterine body or lower segment during delivery or pregnancy. It is a serious obstetric complication that threatens the lives of mother and child. The main causes of death were hemorrhage and infectious shock. With the improvement of obstetric quality, the establishment and gradual improvement of urban and rural maternal and child health care networks, the incidence rate has dropped significantly. It is rarely seen in urban hospitals, but occurs occasionally in remote rural areas. Most uterine ruptures occur after 28 weeks of gestation, most commonly during delivery. The incidence is currently controlled below 1‰, with a maternal mortality rate of 5% and an infant mortality rate as high as 50% to 75% or even higher.

Uterine rupture often occurs in difficult labor, older women with multiple births, and women who have undergone surgery or had damage to the uterus. According to the cause of rupture, it can be divided into unscarred uterine rupture and scarred uterine rupture.

1. Obstructive dystocia

Factors such as obvious pelvic stenosis, cephalopelvic disproportion, soft birth canal malformation, pelvic tumors and abnormal fetal position hinder the descent of the fetal presenting part. In order to overcome the resistance, the uterus strengthens its contraction, and the lower segment of the uterus is forced to stretch and thin, eventually causing uterine rupture. This type of uterine rupture is the most common type of uterine rupture, and the rupture often occurs in the lower uterine segment.

2. Rupture of uterine scar

The main causes of uterine scar include cesarean section, myomectomy, uterine rupture or perforation repair, uterine malformation correction, etc.; the causes of rupture are mechanical traction of the pregnant uterus leading to rupture of the scar or damage to the endometrium at the uterine scar, placenta implantation, and placenta percreta leading to spontaneous rupture of the uterus. In recent years, the number of cesarean sections has increased rapidly. Cesarean section through longitudinal incision of the uterine body is prone to uterine rupture in subsequent pregnancies. In addition to the different anatomical properties of the longitudinal incision of the uterine body and the lower transverse incision, the role of infection factors should also be considered. Because patients who currently undergo cesarean section through longitudinal incision of the uterine body usually have undergone a long labor process and multiple vaginal examinations, the chance of infection is increased.

3. Abuse of uterotonics

The uterotonics here should include various substances that stimulate uterine contraction, including the most commonly used oxytocin and misoprostol, which has only been used in recent years. There are more and more reported cases of misoprostol causing uterine rupture. The main reasons include excessive drug dosage or too fast administration speed, immature cervix, malposition of fetus, obstructive dystocia, and lack of careful observation of the labor process during medication.

4. Injury during vaginal delivery

The cervix is ​​not fully dilated, and forced forceps delivery or gluteal traction may cause severe cervical laceration that extends upward to the lower uterine segment. Ignoring internal version of the transverse position, abortion, partial artificial placental removal, etc. can all cause uterine rupture due to improper operation.

5. Uterine malformation and uterine wall hypoplasia

The most common are bicornuate uterus or unicornuate uterus.

6. Uterine disease

Multiparous women have a history of multiple curettages, infectious abortions, intrauterine infections, artificial placental removal, and hydatidiform mole, etc. Due to the above factors, the endometrium and even the muscle wall are damaged, and the placenta implants or penetrates after pregnancy, eventually leading to uterine rupture.

The six reasons introduced in detail above are the six main reasons for uterine rupture. So now that we understand these reasons that lead to uterine rupture, our pregnant women can avoid uterine rupture again in their future lives. This is very necessary for our physical health and the physical and mental health of the fetus, so we all must pay attention to it.