SPONTANA RUPTURA MATERICE U TRUDNOĆI

Radojka  Cerović Popović; Radmila  Sparić

doi:10.5937/smclk4-41772

Radojka Cerović Popović Klinika za ginekologiju i akušerstvo Univerzitetski klinički centar Srbije
Radmila Sparić Klinika za ginekologiju i akušerstvo Univerzitetski klinički centar Srbije, Medicinski fakultet Univerzitet u Beogradu https://orcid.org/0000-0003-0515-1951

DOI: https://doi.org/10.5937/smclk4-41772

Ključne reči: ruptura materice, faktor rizika, dijagnoza, tretman

Sažetak

Ruptura materice je životno ugrožavajuća komplikacija trudnoće i povezana je sa visokom učestalošću maternalnog i neonatalnog morbiditeta i mortaliteta. Cilj ovog rada je da prikaže faktore rizika, kliničku sliku, dijagnostičke i terapijske mogućnosti za zbrinjavanje rupture materice. U radu su prikazani podaci iz radova selektovanih pretraživanjem PubMed baze podataka korišćenjem kombinacije ključnih reči: uterine rupture, pregnancy, delivery, risk factors, diagnosis, treatment.

U razvijenim zemljama ruptura materice je najčešće komplikacija prethodnog carskog reza, a ređe drugih operacija na materici. U zemljama u razvoju se javlja češće i obično je posledica opstrukcije porođaja ili neadekvatne upotrebe medikamenata za indukciju i/ili stimulaciju porođaja. Tipična klinička slika rupture materice podrazumeva pojavu abdominalnog bola i znakova hemoragičnog šoka kod trudnice uz poremećaj rada srca fetusa. Nespecifični simptomi i znaci rupture materice predstavljaju otežavajući faktor za pravovremeno postavljanje dijagnoze. Tretman rupture materice zavisi od obima rupture, starosne dobi, pariteta i opšteg stanja pacijentkinje. Primarni cilj hirurškog zahvata je zaustavljanje krvarenja i hemodinamska stabilizacija pacijentkinje, a podrazumeva histerektomiju ili ušivanje materice.

Kao posledica sve veće učestalosti porođaja carskim rezom, koji u novije vreme predstavlja najčešći faktor rizika za nastanak rupture materice u trudnoći i porođaju, ruptura materice i dalje predstavlja veoma značajnu komplikaciju trudnoće. Na rupturu materice treba misliti kod trudnica sa prisutnim faktorima rizika, naročito u slučaju pojave nespecifičnog bola u abdomenu i patoloških promena u kardiotokografskom zapisu. U ovakvim situacijama, postavljanje pravovremene dijagnoze i hitno lečenje mogu značajno doprineti povoljnom, kako maternalnom, tako i neonatalnom ishodu.

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