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In 2015 about 6.5 million cases of obstructed labour or uterine rupture occurred. [5] This resulted in 23,000 maternal deaths down from 29,000 deaths in 1990 (about 8% of all deaths related to pregnancy). [2] [6] [9] It is also one of the leading causes of stillbirth. [10] Most deaths due to this condition occur in the developing world. [1]
Bleeding before childbirth is that which occurs after 24 weeks of pregnancy. [4] Bleeding may be vaginal or less commonly into the abdominal cavity. Bleeding which occurs before 24 weeks is known as early pregnancy bleeding. Causes of bleeding before and during childbirth include cervicitis, placenta previa, placental abruption and uterine rupture.
Couvelaire uterus (also known as uteroplacental apoplexy) [1] is a rare but not a life-threatening condition in which loosening of the placenta (abruptio placentae) causes bleeding that penetrates into the uterine myometrium forcing its way into the peritoneal cavity. This condition makes the uterus very tense and rigid.
Along with placenta previa and uterine rupture it is one of the most common causes of vaginal bleeding in the later part of pregnancy. [6] Placental abruption is the reason for about 15% of infant deaths around the time of birth. [2] The condition was described at least as early as 1664. [7]
Throughout pregnancy, the uterus experiences motor denervation, thus inhibiting spontaneous contractions. The remaining contractions are predominantly hormonally controlled. The decrease in the coordination of uterine smooth muscles cells reduces the effectiveness of contractions, causing the uterus to enter a state of uterine quiescence. [8]
Intra-abdominal bleeding can lead to hypovolemic shock and death. Although the associated maternal mortality is now less than one percent, the fetal mortality rate is between two and six percent when rupture occurs in the hospital. In pregnancy uterine rupture may cause a viable abdominal pregnancy. This is what accounts for most abdominal ...
Obstetric causes of first trimester bleeding include the following: Early pregnancy loss is a term often used interchangeably with spontaneous abortion and miscarriage and refers to pregnancy loss during the first trimester. [7] It is the most common cause of early pregnancy bleeding and is associated only with heavy (versus light) bleeding. [8]
Symptoms include vaginal bleeding, abdominal pain, premature labor and threatened miscarriage. [6] Ultrasonography is the preferred method of diagnosis. [7] A chorionic hematoma appears on ultrasound as a hypoechoic crescent adjacent to the gestational sac. The hematoma is considered small if it is under 20% of the size of the sac and large if ...