What are the symptoms of uterine rupture

Symptoms of uterine rupture mainly include abnormal vaginal bleeding, severe abdominal pain, abnormal fetal heart rate, shock, and changes in uterine contour. Uterine rupture is an obstetric emergency that often occurs during delivery or after uterine surgery and requires immediate medical treatment.

1. Abnormal vaginal bleeding

There may be heavy, bright red bleeding from the vagina when the uterus ruptures, and the blood may be accompanied by blood clots. The amount of bleeding is related to the degree of rupture, and severe cases can lead to hemorrhagic shock within a short period of time. Some patients may first experience a small amount of dark red bleeding, and then the amount of bleeding suddenly increases. This situation needs to be differentiated from obstetric hemorrhage such as placenta previa and placental abruption.

2. Severe abdominal pain

Patients will suddenly experience severe tearing abdominal pain. The pain is mostly in the lower abdomen and may radiate to the shoulders and back. Abdominal pain is often accompanied by tonic contractions of the uterus, and the abdomen appears plate-like and hard on palpation. The degree of pain is related to the extent of rupture, and the pain is more severe in complete uterine rupture. People with a history of uterine surgery should be highly vigilant if they experience such pain.

3. Abnormal fetal heart rate

Fetal heart rate may drop sharply, decelerate, or disappear. This is due to interruption of oxygen supply due to placental detachment following uterine rupture or the fetus entering the abdominal cavity. Fetal heart rate monitoring showed poor baseline variability and frequent late decelerations. In some cases, fetal tachycardia appears first, and then turns to bradycardia until it disappears.

4. Shock performance

As the amount of bleeding increases, patients may develop shock symptoms such as pale complexion, clammy limbs, thin pulse, and decreased blood pressure. The degree of shock is related to the bleeding speed. In severe cases, symptoms such as confusion and anuria may occur. It should be noted that shock symptoms in some patients may lag behind other manifestations.

5. Changes in uterine contour

In complete uterine rupture, abdominal palpation reveals that the outline of the uterus has disappeared and the fetal limbs are easily palpable. In some patients, the contracted lower uterine segment can be palpated above the pubic symphysis. Ultrasound examination may show disruption of myometrial continuity, and fetal or placental tissue may have entered the abdominal cavity.

Uterine rupture is a serious obstetric emergency. Once the above symptoms occur, you should lie down immediately and call for emergency treatment. While waiting for treatment, you should avoid eating and drinking, and stay in a side-lying position to reduce the risk of bleeding. Pregnant women with a history of uterine surgery or scarred uterus should strengthen prenatal check-ups in the third trimester and choose a hospital with rescue conditions for delivery. After delivery, you need to pay attention to the amount of vaginal bleeding and abdominal pain, and follow the doctor's instructions for anti-infective treatment and nutritional support.