Uterine rupture: the road ahead?

Abstract

The worldwide increase in caesarean sections, as well as that in laparoscopic and hysteroscopic surgery, augments the risk for women to suffer a uterine rupture. Also the use of misoprostol for the termination of pregnancy and induction of labour, particularly in developing countries, contributes to the greater incidence of uterine rupture. In developing countries, again, neglected obstructed labour remains a very frequent cause of uterine rupture. Diagnosis of uterine rupture may be difficult and, if made too late, serious and even devastating complications may follow, culminating in infant and/or maternal death. A high index of suspicion is indicated when dealing with women at risk. Options in terms of managing uterine rupture include simple repair of the tear, subtotal, and total hysterectomy. Counselling women before and after surgical interventions on the genital tract, especially caesarean section on request, should include information concerning the subsequent risk of uterine rupture.