1. Home
  2. Knowledge Base
  3. 2.3.2 Clinical presentation

2.3.2 Clinical presentation

Early identification of uterine rupture and immediate intervention is key to reducing morbidity and mortality related to uterine rupture. The following are signs/symptoms that may suggest uterine rupture:

Maternal signs/symptoms

  • Unstable vitals – Hypotension, tachycardia, decreased LOC
  • Pain– intense abdominal pain that persists between contractions (this may be masked by neuraxial analgesia), abdominal peritonitis like rigidity, rebound tenderness
  • Bleeding- vaginal bleeding may or may not be present, depending on where the rupture has occurred
  • Change in abdominal shape- there may be change in the abdominal girth, shape 
  • Palpation of fetal part in abdomen
  • Inability to palpate fundus (if fundal rupture has occurred)
  • Cessation of uterine contractions
  • Free fluid in the abdomen on bedside ultrasound

Fetal signs

  • Fetal heart rate changes- commonly bradycardia with no recovery due to loss of blood supply is the most common objective sign, can also present with variable or late decelerations
  • Loss of station- if rupture has occurred, the fetus may have passed through the rupture into the abdominal cavity and present as a loss of station.

Uterine rupture can also occur post delivery. It is important to do a bimanual exam after delivery to ensure the uterus is intact, particularly if there is significant bleeding post delivery.

Updated on October 5, 2021

Was this article helpful?