1 / 17

Rupture of uterus

Rupture of uterus. Ob & Gy Department, First Hospital, Xi’an Jiao Tong University SHU WANG. Etiology. Fetal descent arrest Surgical delivery history Misuse of oxytocin Obstetrical operative injury. Clinical findings. Impending uterine rupture Abdominal pain and tenderness

justina-wilcox
Download Presentation

Rupture of uterus

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Rupture of uterus Ob & Gy Department, First Hospital, Xi’an Jiao Tong University SHU WANG

  2. Etiology • Fetal descent arrest • Surgical delivery history • Misuse of oxytocin • Obstetrical operative injury

  3. Clinical findings • Impending uterine rupture • Abdominal pain and tenderness • Pathologic retraction ring • Increased uterine irritability • Hematuria • Sign of hypovolemic shock • Fetal distress or fetal death

  4. Clinical findings • Uterine rupture • complete uterine rupture • severe abdominal pain • Sign of hypovolemic shock • PE:abdominal tenderness ;fetal body under abdominal wall;absence of fetal heart • PV:vaginal bleeding;acent of fetal presentation • incomplete uterine rupture • mild symptoms and signs • Haematoma in broad ligment

  5. Diagnosis & differential diagnosis • Diagnosis • History • Symptom • Physical signs • B echo • Differential diagnosis • Severe placenta abruption • Intrauterine infection

  6. treatment • Impending uterine rupture • to inhibit uterine contraction:general anesthesia,dolatin,et al. • cesarean section • Uterine rupture • reverse the shock • perform operation • Preventive antibiotic using

  7. Postpartum hemorrhage • Definition excessive bleeding (>500ml )following 24h after fetal delivery

  8. Etiology • Uterine atony • Generalfactor: • excessive nervous of parturient; • excessive sedative drug; • chronic disease; • weakness,et al.

  9. Obstetrical factor: prolonged labor, previa placenta,placenta abruption, severe anemia; intrauterine infection,et al. Uterine atonyEtiology

  10. Uterine atonyEtiology • Uterine factor: • maldevelopment of myometrium fiber, • malformation of uterine, • overextendeduterien:twins,polyhydramnios

  11. Placenta causation • Retention of placenta tissue • Placenta adhesion • Placenta implant • Retained placenta and membrane tissue

  12. Soft tissue laceration • Rigid perineum • Precipitate or uncontrolled delivery • Inappropriate vaginal surgey • Due to episiotomy

  13. Coagulation defect • Obstetrical complication disease: DIC in amniotic fluid embolism,severe placenta abruption,PIH,fetal death. • Parturient combined with hematological disease

  14. Clinical presentation • Vaginal bleeding • With atony uterine • With placenta retention • With coagulation defect • With large haematoma • Sigh of hypovolemic shock • Dizziness,paleness,mild pulse,hypotension

  15. Diagnosis • Uterine inertia • Placenta examination • Soft tissue laceration • cervix laceration • Vaginal laceration • Perinium laceration • Coagulation defection • History • Symptom • Laboratory investigation

  16. Treatment • Uterine atony • Explore the reason of bleeding • Uterine massage • Oxytocin infusion • intrauterine bandage padding • Pelvic vessel ligation • hysterectomy

  17. Treatment • Retained placenta tissue • manual exploration of the uterine • curretage • Soft tissue laceration • repair the laceration • Clear the haematoma • Coagulation defect • blood replacement

More Related