Most common cause of rupture uterus?
Ans. a (Separation of previous caesarean scar) (Ref. Dutta obst. 6th ed460)RUPTURE UTERUSDefinition: Dissolution in the continuity of uterine wall anytime beyond 28 weeks of pregnancy.Etiology# Spontaneous rupture during pregnancy: Complete and involves upper segment of uterus. Obstructive rupture during labour: Involves lower segment.# Non-obstructive rupture during labour: Complete and involves fundus.# Incidence of scar rupture is 1-2 % in lower segment scar and 5-10 times more in classical scar.# Obstructive rupture which is an end result of obstructed labour due to neglect in intranatal care involves lower segment and usually extends through one lateral side of uterus to the upper segment. Additionally, oxytocin should not be used in women with prior classic cesarean section scars because the risk of uterine rupture is high (5%-10%).Features of Uterine rupture (during labour)a) Failure in progress of labour.b) Suprapubic pain.c) Slight bleeding PV and Hematuria.d) Alteration in fetal heart rate.e) Unexplained maternal tachycardia.f) Hypotension.g) Tenderness over scar.h) Bladder tenesmus.i) Ballooning of lower segment
Separation of previous caesarean scar
Internal version
Excess dosage of oxytocin
Complicated manual removal of placenta
Miscellaneous (Gynae)