Procedural Manual For Delivery Cases

Causes of Uterine Rupture:

• Use of uterine stimulants without proper monitoring.
• Pressure on the uterus or abdomen during delivery.
• Multiple previous pregnancies (more than five).
• Mismatch between fetal head size and pelvic size.
• Abnormal fetal position, such as a posterior vertex.
• Uterine tumors or fibroids blocking the baby’s descent.
• Birth defects or twin pregnancies.

Signs of Impending Uterine Rupture:

• Severe lower abdominal pain due to strong, continuous uterine contractions.
• Mild vaginal bleeding.
• Difficulty distinguishing fetal parts due to the tight contraction of the uterus.

Signs of Actual Uterine Rupture:

• Sudden and intense abdominal pain, followed by cessation of uterine contractions.
• Shock symptoms due to bleeding.
• Fetal parts may be palpable upon abdominal examination.
• Vaginal bleeding, and the cervix may be dilated with visible uterine rupture.

Nursing Care for Uterine Rupture:

• Nurses play an essential role in identifying warning signs and preventing uterine rupture.
• In case of rupture, two IV cannulas should be inserted, fluids should be administered, and blood transfusions should be prepared.
• Emergency management should be carried out, and the patient should be prepared for exploratory surgery as per medical instructions.