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A hysterorrhexis is a rupture of the uterus.

Diagnosis and treatment:

The diagnosis is sometimes obvious but may be impossible without laparotomy. Persistent

abdominal pain, a rise in pulse rate and fresh vaginal bleeding should be looked for. Rupture

is followed by cessation of contractions. If the fetus is wholly or partly extruded into the

abdominal cavity the uterus will contract and may be detectable as a separate mass in the

abdomen. Vaginal examination reveals an empty pelvis.

Once the diagnosis is reached, laparotomy

must be carried out with blood transfusion

set up.

Hysterectomy may be the safest treatment,

but this decision will depend on the extent of

the damage and the patient's parity. If the

tear is small it can be repaired with

conservation of the uterus.

If hysterectomy is decided on, the tear will in most cases have half completed the operation.

Subsequent steps in the operation are indicated below. If bleeding is severe this will be an

operation in which speed is of importance.

Refrences:Kevin P. Hanretty: Obstetrics Illustrated (sixth edition); Churchill Livingstone
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