[Diversity of symptoms in uterine rupture]

We analyzed 5 cases of uterine rupture observed in our clinic in the last 8 years (= 0.36 per 1000 deliveries) because spontaneously appearing ruptures of a normal uterus often have symptoms which may mislead our efforts like amniotic fluid infusion or clotting defects. All our 5 cases were multiparous women, in 4 cases oxytocic drugs were applied and only in one case there was a histologic damage of the myometrium. In no case classic sharp pain and cessation of contractions could be observed, only in one case painful abdomen and tenderness of the uterus. On the other hand shock could be seen in every case, vaginal bleeding in 4 cases and alteration of fetal heart frequency in 3 of 4 cases with primary living fetus. The different symptoms may occur as to time in a variable sequence. Therefore the right diagnosis is made often very late. In accordance with the literature a digital control of the uterine cavity is proposed in every case of an acute event during childbirth, especially evidence of shock, also if another diagnosis than rupture of the uterus is more probable.