Evaluation of obstetricians’ surgical decision making in the management of uterine rupture

Eze, Justus N.; Anozie, Okechukwu Bonaventure; Lawani, Lucky Osaheni; Ndukwe, Emmanuel; Agwu, UM; Obuna, JA

doi:10.1186/s12884-017-1367-8

Cited by 7 publications

(3 citation statements)

References 29 publications

(70 reference statements)

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“…The rate in some regions reached 71.588% 21 . Therefore, the first step to reduce the rate of cesarean section is to reduce the number of cesarean sections performed without indications 5,22,23 …”

Section: Discussionmentioning

confidence: 99%

Ultrasonic manifestations and clinical analysis of 25 uterine rupture cases

Xiao

Zhang

Yun

et al. 2021

J of Obstet and Gynaecol

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Purpose To explore the risk factors, ultrasonic manifestations, clinical features, and maternal and neonatal outcomes associated with complete uterine rupture. Basic procedures All cases of complete uterine rupture diagnosed and treated in Jiangxi Maternal and Child Health Hospital from January 2012 to July 2018 were retrospectively analyzed. Risk factors, ultrasonic manifestations, clinical features, and maternal and infant outcomes were analyzed. Result All patients had a history of uterine surgery or induced abortion. Ultrasound examination revealed 15 cases of complete rupture of the uterus, five cases of missed diagnosis, three cases of misdiagnosis, and two cases of direct emergency operation without ultrasonography because of typical clinical manifestations and critical conditions. The clinical manifestations of 25 cases of uterine rupture varied from asymptomatic to clinical signs of “resting” rupture of the uterus to severe pain, hypotension, shock, and coma. All patients underwent surgical treatment, of which one case underwent DIC and died after rescue. The maternal mortality rate was 4% (1/25), the mortality rate of newborns (two pregnant women was twins) was 44% (12/27). Conclusion A history of uterine surgery is a major risk factor for uterine rupture. Attention should be paid not only to women who are pregnant again after cesarean section but also to those who have undergone other uterine operations (such as laparoscopic myomectomy, laparoscopic cornual pregnancy removal, etc.), delivery plans should be formulated accordingly. In cases of sudden abdominal pain during pregnancy or childbirth, the possibility of uterine rupture should be considered to achieve a timely and correct diagnosis and treatment.

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Section: Discussionmentioning

confidence: 99%

Ultrasonic manifestations and clinical analysis of 25 uterine rupture cases

Xiao

Zhang

Yun

et al. 2021

J of Obstet and Gynaecol

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“…A promoção do atendimento qualificado no nascimento, a identificação das mulheres de alto risco e o encaminhamento oportuno, o uso de drogas oxitócicas com cautela, o uso correto do partograma, a prevenção de cesáreas desnecessárias e a educação de pessoas sobre a gravidez supervisionada e o parto são essenciais para reduzir as ocorrências de RU 42 . O objetivo final deve ser evitar a fatalidade e reduzir a morbidade materna e fetal 52 . E, a laparotomia imediata é a chave para um tratamento bem sucedido 26 .…”

Section: Discussionunclassified

Rotura uterina: uma revisão de literatura

Machado¹,

Moraes²

2017

Rev Pat Tocantins

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Direitos Autorais: © 2017 Machado et al. Este é um artigo de acesso aberto que permite o uso, a distribuição e a reprodução sem restrições em qualquer meio, desde que o autor original e a fonte sejam creditados. Conflito de interesses RESUMOIntrodução: A ruptura uterina (RU) é uma emergência obstétrica com o maior risco de morbidade e mortalidade para a mãe e principalmente para o feto. Apesar da ausência de definição consistente na literatura, a RU pode ser descrita como deiscência ou ruptura da parede do útero, precedendo eventos sintomáticos ou clinicamente significativos. Objetivo: abordar a RU por meio de revisão da literatura existente, a fim de fornecer dados atualizados aos profissionais que lidam com essa complicação obstétrica. Metodologia: Foi realizada uma pesquisa nas bases Science Direct, Pub Med e Google Scholar para publicações de dezembro de 2012 a agosto de 2017 sobre a ocorrência de ruptura uterina utilizando a palavra chave: uterine break. Foram incluídos para a revisão 53 artigos. Os dados encontrados nos relatos de casos foram analisados em frequências absolutas e relativas. Resultados: Em revisão dos relatos de caso encontrados, constatou-se que o principal sintoma relatado pelas pacientes no momento do diagnóstico de RU foi dor abdominal intensa. A idade média relatada das pacientes foi de 30,14 anos. A maioria encontrava-se no terceiro trimestre de gestação (51,85%). Ocorreu morte fetal em 64,28% dos casos e nenhuma morte materna foi relatada. A principal conduta obstétrica foi a laparotomia exploradora (LE) (85,71%). A localização do defeito uterino ocorreu principalmente na parede anterior, e a causa provável mais relatada foi a deiscência de cicatriz prévia (35,71%). Constatamos que o fator de risco (FR) para RU mais citado foi cesariana anterior/cicatriz uterina. Conclusão: A RU deve ser pensada como diagnóstico possível sempre que uma gestante se apresente com dor abdominal aguda e presença de coleção líquida na cavidade peritoneal, mesmo que esteja no início da gestação e não apresente FR identificados na história obstétrica. Palavras-chave: Ruptura uterina, Gravidez, Ruptura uterina na gravidez, Desfecho materno, Desfecho fetal. ABSTRACTIntroduction: Uterine rupture (UR) is an obstetric emergency with the highest risk of morbidity and mortality for the mother and especially for the fetus. Despite the lack of consistent definition in the literature, UR can be described as dehiscence or rupture of the uterine wall, preceding symptomatic or clinically significant events. Objective: to approach the UK through a review of the existing literature, in order to provide updated data to professionals dealing with this obstetric complication. Methodology: A study was carried out at the bases Science Direct, Pub Med and Google Scholar for publications from December 2012 to August 2017 on the occurrence of UR using the key word: uterine break. 53 articles were included for the review. Data found in the case reports were analyzed in absolute and relative frequencies. Results: In review of the ...

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“…Preference for partial or subtotal to total cesarean hysterectomies by less experienced obstetricians is a wise decision during the learning curve. 25 …”

Section: Methodsmentioning

confidence: 99%

A Review on the Etiology, Prevention, and Management of Ureteral Injuries During Obstetric and Gynecologic Surgeries

Ade-Ojo¹,

Tijani²

2021

IJWH

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Iatrogenic ureteral injuries are a rare but serious complication of some gynecological and obstetric procedures with both high morbidity and legal implications. The incidence varies widely depending on the type and extent of the surgeries with about 70% unrecognized intraoperatively. When recognized intraoperatively and promptly managed, the prognosis is good. Ureteral injuries recognized postoperatively come with dire consequences for the patients and are litigation prone. Due to the proximity of the lower half of the ureters to the pelvic organs, 50% of the cases of injuries to the ureter occur within the jurisdiction of gynecological and obstetric practice. A good knowledge of the etiology, predisposing factors, appropriate surgical skills, proper identification of the course and deviation of the ureters, and intraoperative recognition of inadvertent damage to the ureter and its vasculature is required by all obstetricians and gynecologists to reduce the incidence of ureteral injuries by at least 50%. This review aims to add to what is already known, particularly among obstetricians and gynecologists practicing in resource-constrained settings.

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Evaluation of obstetricians’ surgical decision making in the management of uterine rupture

Cited by 7 publications

References 29 publications

Ultrasonic manifestations and clinical analysis of 25 uterine rupture cases

Ultrasonic manifestations and clinical analysis of 25 uterine rupture cases

Rotura uterina: uma revisão de literatura

A Review on the Etiology, Prevention, and Management of Ureteral Injuries During Obstetric and Gynecologic Surgeries

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