All are seen with scar dehiscence, except:
(A) Maternal bradycardia (B) Fetal bradycardia (C) Vaginal bleeding (D) Hematuria
(A) Uterine rupture typically is classified as either complete (all layers of the uterine wall separated) or incomplete (uterine muscle separated but visceral peritoneum is intact). Incomplete rupture is commonly referred to as scar dehiscence.
Scar dehiscence is an intraoperative finding always. The greatest risk factor for either complete or incomplete uterine rupture is prior cesarean delivery.
Following uterine rupture the most common electronic fetal monitoring finding is sudden, severe heart rate decelerations that may evolve into late decelerations, bradycardia, and undetectable fetal heart action.
In some cases in which the fetal presenting part has entered the pelvis with labor, loss of station may be detected by pelvic examination. If the fetus is partly or totally extruded from the site of uterine rupture, abdominal palpitation or vaginal examination may be helpful to identify the presenting part, which will have moved away from the pelvic inlet.
A firm contracted uterus may at times be felt alongside the fetus. With rupture and expulsion of the fetus into the peritoneal cavity, the chances for intact fetal survival are dismal, and reported morality rates range from 50% to 75%.
Clinical features of Ruptured Uterus: