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Research Finds Delays in Diagnosis of Uterine Rupture a Significant Cause of Death and Hypoxic-Ischemic Encephalopathy

 

Researchers studying infant outcomes after a complete uterine rupture have found that there is a significant increase in death and in Hypoxic-Ischemic Encephalopathy when a diagnosis of uterine rupture and delivery are delayed.

In a study published in the American Journal of Obstetrics and Gynecology[1], researchers from Norway reported on the results of their study looking at infant outcomes after complete, versus partial, uterine rupture.  Uterine rupture is a life-threatening complication in which the uterus tears open causing bleeding and sometimes causing the baby to be extruded from the uterus into the mother’s abdominal cavity.  The study was conducted to determine what risk factors were associated with poor infant outcome in cases where there is a complete uterine rupture.

The researchers found that when the time between the diagnosis of the uterine rupture and delivery is greater than 30 minutes, there is significantly increased risk of death or serious injury, including hypoxic-ischemic encephalopathy.  In addition, when the complete uterine rupture causes placental separation (placental abruption) or loss of uterine contractions, the risk of death or injury was significantly increased.  The researchers also found that in the cases in which delivery of the baby following complete uterine rupture occurred after midnight, there was a significantly increased risk of death or serious injury.

This research supports the conclusion that prompt recognition and diagnosis of uterine rupture and timely action to deliver the baby can prevent serious injury or death.

Source: [1] Al-Zirqi I, Daltveit AK, Vangen S., Infant outcome after complete uterine rupture. Am J Obstet Gynecol 2018; 219:109.e1-8.

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