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Uterine rupture: Midwifery emergency management

CPD Hours



Critical care and emergency nursing
Midwifery and child health
Clinical practice and procedures
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Rupture of the uterus, although uncommon, is an obstetric emergency that poses a significant threat to both maternal and fetal life. For these reasons, the midwife must be able to recognise the women in her care, who may be at risk of uterine rupture, the signs and symptoms of a uterine rupture and the immediate and ongoing interventions that may be required.

There are many factors that are known to increase the risk for uterine rupture but even in high risk groups the overall incidence of uterine rupture is low.

Uterine rupture occurs in 0.05 % to 0.086 % of all pregnancies.

Dehiscence of a caesarean section scar is the most common cause of uterine rupture and the incidence varies according to type and location of the uterine incision.

Prolonged fetal bradycardia is the first sign in 70% of all uterine ruptures.

However, with the increasing trend for  women to achieve a vaginal birth after caesarean section (VBAC), the risk of a midwife encountering this emergency increases. The aim of this module is to refresh midwives’ knowledge in the event that this  obstetric emergency is encountered and  to serve as a tool for collegial discussion, reflection and evidence based practice review.

Learning Objective

At the end of this module participants will be able to:

  • Define uterine rupture.
  • Recognise and describe the risk factors associated with uterine rupture.
  • Differentiate between the types and classifications of uterine rupture.
  • Recognise the signs and symptoms of uterine rupture.
  • Describe the clinical management of uterine rupture.
  • Describe preventative measures with regard to uterine rupture.
  • Facilitate postpartum debriefing following uterine rupture.

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