ANTEPARTUM UTERINE RUPTURE: A LITERATURE REVIEW

Oktabr, 2025-Yil 61 ANTEPARTUM UTERINE RUPTURE: A LITERATURE REVIEW Shamsieva Dilnoza Alisherovna Academic degree: PhD candidate https://doi.org/10.5281/zenodo.17311095 Introduction. Antepartum uterine rupture is a rare but life-threatening obstetric emergency that occurs before the onset of labor. Unlike intrapartum rupture, it develops spontaneously and is most often associated with uterine scarring following previous surgical procedures such as cesarean section, myomectomy, or reconstructive surgery. The reported incidence varies from 1 in 5,000 to 1 in 20,000 pregnancies and is rising due to the global increase in cesarean deliveries. Despite its rarity, antepartum rupture remains a significant cause of maternal and perinatal morbidity and mortality, especially in low-resource settings. Methods. This literature review was based on a synthesis of international and regional publications indexed in PubMed, Scopus, and eLibrary databases between 2000 and 2024. The search included terms “antepartum uterine rupture,” “uterine scar dehiscence,” “cesarean section complications,” and “maternal outcomes.” Studies describing pathogenesis, diagnostic approaches, clinical presentation, and management strategies were analyzed. Priority was given to systematic reviews, case series, and clinical guidelines from the World Health Organization and professional obstetric associations. Results and Discussion. The main etiological factors identified include scar dehiscence due to inadequate healing, myometrial thinning at the site of previous incision, and abnormal placentation (placenta accreta spectrum). Less common causes involve uterine malformations, trauma, and excessive uterine distension in multiple pregnancies or polyhydramnios. Clinical manifestations are often nonspecific—abdominal pain, fetal distress, peritoneal irritation, or cessation of fetal movements. Imaging methods such as ultrasound and MRI play a critical role in early diagnosis. Emergency laparotomy remains the cornerstone of management, with uterine repair or hysterectomy depending on the extent of rupture and the patient's reproductive plans. Conclusions. Antepartum uterine rupture, though rare, carries a high risk of maternal and fetal death. Early recognition, risk assessment in women with uterine scars, and multidisciplinary management are essential for improving outcomes. Developing standardized diagnostic algorithms and surveillance protocols for high-risk pregnancies remains a global priority. Keywords: Antepartum uterine rupture; cesarean scar; placenta accreta; uterine dehiscence; maternal morbidity; obstetric emergency. References: 1. Pourali L, Saghafi N, Eslami Hasan Abadi S, et al. Induction of labour in term premature rupture of membranes; oxytocin vs. sublingual misoprostol; A randomised clinical trial. J Obstet Gynecol. 2018;38(2):167-171. 2. Mercer BM. Preterm premature rupture of the membranes. Obstet Gynecol. 2003;101(1):178-193. 3. 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