子宫破裂.ppt
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Rupture of uterus
子宫破裂
Lin Jianhua M.D., Ph.D., Professor
Department Of Obstetrics & Gynecology
Renji Hospital Affiliated to SJTU School of Medicine
Definition
? Separation of the muscular wall of the uterus
? usually occurs during labor
? occasionally happen during the later weeks of pregnancy
causes
During pregnancy
? weak scar after previous operations on the uterus
? History of cesarean section (VBAC,vaginal birth after c- section)
? myomectomy
? excision of a uterine septum
? previous perforation of uterus(D&C, hysteroscopy, forceps delivery
During labor:
? uterine hyper-stimulation(oxytocin with pitocin induction or argmentation of labor)
? obstructed labor(macrosomia, feopelvic dispropotion)
? intrauterine manipulation(internal version,manual removal of an adherent placenta)
? forcible dilatation(cervical tear)
? a weak scar(C-section or other operations)
types
? Incomplete rupture
? complete rupture
? depending on whether the peritoneal coat is torn through or not
Symptoms and signs
1. Rupture of scar
? be gradual that symptom is very slight in incomplete rupture
? abdominal pain wrongly attributed to the onset of labor
? severe pain and shock occurs in complete (suddenly pain)
? fetal distress
? bleeding in vagina
2.Spontaneous rupture during obstructed labor
? prolonged labor
? violent uterine actions,? *pathologic retraction ring
? disporpotion, malpresentation(transverse lie)
? fetal distress
? a sharp, tearing pain in lower abdomen
? pulse rapid
? blood pressure fall
? fetus may be felt in the abdominal cavity
3. Rupture by oxytocin drugs:
? be follow the administration of oxytocin
? the danger is less if the drug is given as a dilute intravenous drip given in an increasing fashion
Prognosis
? has a high mortality
? peri-natal morbidity is high
treatment
? Women's general condition must be improved
giving morphome, blood transfusion,glucose solution)
? immediate laparotomy
? hysterectomy
? wide-spectrum antibiotics
Key word
? The causes of the rupture of the uterine
? pathologic retraction ring
THANKS FOR YOUR ATTENTION
Rupture of uterus
子宫破裂
Lin Jianhua M.D., Ph.D., Professor
Department Of Obstetrics & Gynecology
Renji Hospital Affiliated to SJTU School of Medicine
Definition
? Separation of the muscular wall of the uterus
? usually occurs during labor
? occasionally happen during the later weeks of pregnancy
causes
During pregnancy
? weak scar after previous operations on the uterus
? History of cesarean section (VBAC,vaginal birth after c- section)
? myomectomy
? excision of a uterine septum
? previous perforation of uterus(D&C, hysteroscopy, forceps delivery
During labor:
? uterine hyper-stimulation(oxytocin with pitocin induction or argmentation of labor)
? obstructed labor(macrosomia, feopelvic dispropotion)
? intrauterine manipulation(internal version,manual removal of an adherent placenta)
? forcible dilatation(cervical tear)
? a weak scar(C-section or other operations)
types
? Incomplete rupture
? complete rupture
? depending on whether the peritoneal coat is torn through or not
Symptoms and signs
1. Rupture of scar
? be gradual that symptom is very slight in incomplete rupture
? abdominal pain wrongly attributed to the onset of labor
? severe pain and shock occurs in complete (suddenly pain)
? fetal distress
? bleeding in vagina
2.Spontaneous rupture during obstructed labor
? prolonged labor
? violent uterine actions,? *pathologic retraction ring
? disporpotion, malpresentation(transverse lie)
? fetal distress
? a sharp, tearing pain in lower abdomen
? pulse rapid
? blood pressure fall
? fetus may be felt in the abdominal cavity
3. Rupture by oxytocin drugs:
? be follow the administration of oxytocin
? the danger is less if the drug is given as a dilute intravenous drip given in an increasing fashion
Prognosis
? has a high mortality
? peri-natal morbidity is high
treatment
? Women's general condition must be improved
giving morphome, blood transfusion,glucose solution)
? immediate laparotomy
? hysterectomy
? wide-spectrum antibiotics
Key word
? The causes of the rupture of the uterine
? pathologic retraction ring
THANKS FOR YOUR ATTENTION
附件资料：
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