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The uterus provides the connection between the mother and the placenta to nourish the baby in the womb. The uterus also provides a safe space for the baby to develop until it is time to be delivered. A uterine rupture is a tear in the uterus that may cause the baby to exit into the abdomen, putting the mother and baby at risk of harm.
Uterine ruptures are rare but they are serious conditions that need to be treated with immediate care to protect the mother and baby. There are a number of possible causes of uterine rupture. When a uterine rupture is caused by a medical error or the doctor does not properly treat the rupture, medical negligence may cause serious injury to the mother and baby.
What is a Uterine Rupture?
The uterus is an organ in the female pelvis. The uterus is connected to the fallopian tubes where an egg produced by the ovaries implants in the uterine wall where it can be fertilized. If the egg is fertilized, the uterus can provide nourishment to the developing fetus until the baby is ready to be delivered.
The baby is connected to the uterus by the placenta, which develops during pregnancy. The placenta attaches to the wall of the uterus and provides oxygen and nutrients, and carries away waste through the umbilical cord to the baby. During pregnancy, the baby is pushed out of the uterus, through the vagina, with the placenta expelled at the last stage.
Uterine rupture is a rare but serious condition that can occur during pregnancy or labor. When the uterus ruptures, the baby can slip out of the uterus and into the abdominal cavity. This can be dangerous for the mother and the baby and needs to be treated immediately.
Placental Abruption
A uterine rupture is different from placental abruption. As part of childbirth, the placenta separates from the uterus but the uterus remains intact. In a typical pregnancy, the placenta is delivered after the child is born. In placental abruption, the placenta separates from the uterus before giving birth. This pregnancy complication can put the mother and baby at risk of injury or death.
Placental abruption can occur at any time but is more common around the end of the second trimester or beginning of the third trimester. Placental abruption occurs in about 1% of all pregnancies. The extent of an abruption can range from small and minor to significant abruptions that require emergency surgery.
Risks of Uterine Rupture to the Mother and Baby
There are risks to both the mother and the baby after a uterine rupture. For the mother, a uterine rupture can cause serious bleeding. Hemorrhage can cause serious blood loss, putting the mother at risk of hemorrhagic shock, brain damage, cardiac arrest, organ failure, or death.
For the baby, the major risk of a uterine rupture involves suffocation or hypoxic-ischemic encephalopathy. If the placenta separates from the uterus during uterine rupture, it can cut off the supply of oxygenated blood to the baby through the umbilical cord. Without the blood supply, the baby cannot get enough oxygen and may begin to suffer hypoxia, or low oxygen levels to the brain.
If the baby does not get oxygen restored quickly, it can cause brain damage or death. According to the American Family Physician, the best outcomes are found when surgical delivery is accomplished within 17 minutes from the onset of fetal distress. Generally, about 2.6% of babies do not survive uterine rupture, which increases to 6% if the uterine rupture occurred before the mother was able to get to the hospital.
Causes of Uterine Rupture
Uterine ruptures are much more common in women who have had prior cesarean deliveries. The risk of uterine rupture increases with the number of C-sections and the tear in the uterus generally occurs along the healed scar lines from the C-section. Uterine abnormalities, trauma, or surgery to the uterus may also increase the risk of uterine rupture. Causes of uterine rupture may include:
- Overdistention with multiple pregnancies
- Overdistention with excessive amniotic fluid
- Fetal version to turn a fetus from breech or sideways position to head down
- Perforation of the colon and rectum
- Excessive uterotonics to induce labor
- Difficult labor
Treating a Uterine Rupture
Treating uterine rupture beings with identifying the condition. The signs and symptoms of a uterine rupture may include:
- Irregular fetal heart rate
- Fetal distress
- Hypovolemia
- Severe or constant abdominal pain
However, in many cases, the symptoms may appear like other conditions and be nonspecific. Diagnosis can be difficult and signs of distress may require emergency delivery or C-section. Uterine rupture is generally diagnosed after surgery.
Treatment of the mother generally involves controlling blood loss. Depending on the extent of the injury, treatment may involve removal of the uterus, or a hysterectomy. After a hysterectomy, a woman is no longer able to get pregnant.
For the baby, treatment generally involves emergency delivery of the baby to resuscitate the baby and provide oxygen and support. If the baby is resuscitated quickly and there was no extended oxygen deprivation, the child may recover with no serious injuries. If oxygen deprivation did occur, the extent of the damage generally depends on how long the baby’s brain was without a sufficient oxygen supply. Oxygen deprivation can cause developmental delays, cerebral palsy, or brain death.
Malpractices Causes and Failure to Treat Uterine Rupture
Uterine rupture can be caused by medical malpractice. In a medical procedure on a pregnant woman, improper doses of medications or improper surgical treatment can cause the uterus to rupture, putting the mother and baby at risk of injuries.
Medical malpractice may also involve failure to properly treat a uterine rupture. Time is of the essence after a uterine rupture because every minute that passes before the baby is delivered may increase the risk of brain injury or death. Malpractice could involve failure to identify fetal distress, failure to monitor the mother and baby, or delayed C-section delivery.
Uterine Rupture Malpractice Lawyer
If a child suffers a brain injury as the result of medical negligence involving a uterine rupture, talk to an experienced birth injury attorney about your rights. If you have questions about possible medical mistakes during pregnancy or delivery, do not hesitate to contact Gilman & Bedigian today for a free consultation.