Uterine Rupture
Considerations
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True emergency and potentially disastrous for both mom and baby
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Requires immediate resuscitation and preparation for emergency surgery, possibly under general anesthesia
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Pregnancy considerations (difficult intubation, aspiration, quick desaturation, aortocaval compression, 2 patients)
Management
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Call for help
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Emergency situation for both mother and fetus
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Prepare for most likely a general anesthetic for delivery and management. More stable patients may be managed with spinal or pre-existing epidural
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Resuscitation needs to be initiated ASAP with the preparation for possible massive transfusion. Will need:
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Large bore IV access and possibly a central line
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Arterial line monitoring
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Availability of blood products
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References
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Banayan JM, Hofer JE, Scavone BM. Antepartum and Postpartum Hemorrhage. In: Chestnut DH, Wong CA, Tsen LC, et al, editors. Chestnut's Obstetric Anesthesia: Principles and Practice. Sixth Edition. Philadelphia, PA: Elsevier; 2020. p. 901-936