Malpresentations and Positions & Operative Obstetrics
Hematuria during labour in previous LSCS is sign of :- (AIIMS Nov. 2009)
|A||Impending rupture of scar|
Impending rupture of scar
This is because of the stretching of the veins at the base of the bladder. Also, it is 'NOT' because of a bladder rupture along with a uterine cesarean scar rupture.
a. Uterine scar dehiscence
There is separation of a preexisting scar that does not disrupt the overlying visceral peritoneum. In addition, the fetus, placenta, and umbilical cord must be contained within the uterine cavity, without a need for cesarean delivery because of fetal distress.
b. Uterine rupture
This is defined as a full-thickness separation of the uterine wall and the overlying serosa.
c. Causes of uterine rupture
i. Previous cesarean delivery
ii. Previous myomectomy
iii. Pregnancy complications like Grand multiparity, Maternal age, Placentation (accreta, percreta, increta, previa, abruption) Cornual (or angular) pregnancy.
iv. Overdistention (multiple gestations, polyhydramnios).
d. Other signs of rupture uterus are
i. Uterine rupture is associated with clinically significant uterine bleeding and fetal distress.
ii. Fetal distress (The patterns of prolonged decelaration also is very common on CTG)
iii. Diminished baseline uterine pressure,
iv. Loss of uterine contractility,
v. Abdominal pain,
• Recession of the presenting fetal part,
• Hemorrhage, and shock