Enfoques y desafíos en el manejo de la ruptura uterina

Abstract

Objective: To review the approaches and challenges in obstetric management of uterine rupture cases, including the main clinical signs and symptoms, as well as methods for early diagnosis, prevention, and monitoring of pregnant women with risk factors. Methods: An integrative literature review was conducted using the PubMed and BVS databases, with the descriptors “uterine rupture,” “dehiscence,” and “management.” Articles published between 2015 and 2025 in English, Portuguese, and French were selected. Results: The final sample consisted of 16 articles. It was observed that changes in fetal heart rate tracing represent the main finding for early detection, while sudden abdominal pain, vaginal bleeding, Bandl-Frommel sign and ultrasonographic findings complement the clinical presentation. Immediate management of hemorrhage should be performed simultaneously with surgical intervention, with the involvement of a multidisciplinary team. Although ultrasound assessment of the lower uterine segment shows potential as a predictive tool for dehiscence and rupture, there is still no consensus on reliable parameters, highlighting the need for further studies. Final considerations: Rigorous surveillance, early recognition of clinical signs, and a structured obstetric management approach are essential to reduce maternal perinatal morbidity and mortality associated with uterine rupture.