Hemorrhagic Shock Due to Uterine Rupture

Pregnancy causes multisystem changes including changes to the cardiovascular and hematologic systems. These changes must be considered when managing emergencies in the third trimester. Uterine rupture is more likely to occur in patients with prior cesarean operation but can occur in any parturient and should be on the differential in patients with sudden abdominal pain, vaginal bleeding, and fetal instability. This chapter will review the signs and symptoms of uterine rupture and management of hemorrhagic shock and discuss risk factors for uterine rupture and intraoperative management of uterine rupture and hemorrhage. In addition, this comprehensive chapter contains the materials needed to develop and implement a successful simulation including a case scenario, narrative, and progression as well as a scoring rubric for evaluation of the management of uterine rupture and hemorrhagic shock.