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Может произойти как во время беременности (не более 10%), так и при родах (более 90%) [5](https://ProBolezny.ru/razryv-matki/). \n\nПо степени повреждения стенки разрывы матки делятся на две группы [1](https://www.KrasotaiMedicina.ru/diseases/zabolevanija_gynaecology/uterine-rupture): \n1. **Полные** — повреждаются эндо-, мио- и периметрий, формируется отверстие между маточной и брюшной полостью, через которое может выходить плод [1](https://www.KrasotaiMedicina.ru/diseases/zabolevanija_gynaecology/uterine-rupture). \n2. **Неполные** — ограничиваются только эндометрием и/или миометрием, основное проявление — образование гематомы под висцеральной брюшиной или между листками широкой связки [1](https://www.KrasotaiMedicina.ru/diseases/zabolevanija_gynaecology/uterine-rupture).\n\n\n\n## Причины\nНекоторые факторы, повышающие риск разрыва матки: \n* **Перерастяжение матки** — многоплодие, многоводие, неправильное положение плода [6](https://nutrilak.com/article/razryvy-v-rodah-kak-ih-izbezhat/). \n* **Затруднение прохождения плода по родовому каналу** — разгибательные вставления головки, выраженные рубцовые изменения шейки матки, опухоли матки, узкий таз, крупный плод [6](https://nutrilak.com/article/razryvy-v-rodah-kak-ih-izbezhat/). \n* **Изменение тканей матки** — рубец на матке после операции кесарева сечения, воспалительные процессы матки, изменение стенок матки на фоне предыдущих прерываний беременности [6](https://nutrilak.com/article/razryvy-v-rodah-kak-ih-izbezhat/). \n\nЧасто оба фактора сочетаются: разрыв происходит в результате комбинации механического препятствия при естественных родах и изменённой ткани матки [5](https://ProBolezny.ru/razryv-matki/).\n\n## Симптомы\nВыделяют угрожающий, начавшийся и совершившийся разрыв матки [1](https://www.KrasotaiMedicina.ru/diseases/zabolevanija_gynaecology/uterine-rupture)[6](https://nutrilak.com/article/razryvy-v-rodah-kak-ih-izbezhat/): \n* **Угрожающий** — стенки матки истончены, болезненность схваток нарастает, время между схватками стремительно уменьшается, затрудняется мочеиспускание [6](https://nutrilak.com/article/razryvy-v-rodah-kak-ih-izbezhat/). \n* **Начавшийся** — усиление симптоматики, появление учащённого сердцебиения, дыхания, чувства беспокойства, крови в моче, кровянистых выделений из половых путей, ухудшение состояния плода [6](https://nutrilak.com/article/razryvy-v-rodah-kak-ih-izbezhat/). \n* **Совершившийся** — одномоментная острая кинжальная боль в животе, прекращение родовой деятельности, резкое утяжеление состояния матери, чаще гибель плода [6](https://nutrilak.com/article/razryvy-v-rodah-kak-ih-izbezhat/).\n\n## Диагностика\nДля постановки диагноза врач проводит гинекологический осмотр пациентки и собирает анамнез [3](https://centr-hirurgii.ru/surgery/operativnaya-ginekologiya/povrezhdeniya-matki/)[4](https://smart-hirurgiya.ru/services/operativnaya-ginekologiya/zabolevaniya-og/povrezhdeniya-matki/). В зависимости от причины возникновения травмы назначают дополнительные исследования [3](https://centr-hirurgii.ru/surgery/operativnaya-ginekologiya/povrezhdeniya-matki/). Например: \n* трансвагинальное УЗИ органов брюшной полости [3](https://centr-hirurgii.ru/surgery/operativnaya-ginekologiya/povrezhdeniya-matki/); \n* гистероскопия полости матки [3](https://centr-hirurgii.ru/surgery/operativnaya-ginekologiya/povrezhdeniya-matki/).\n\n## Лечение\n**При появлении первых симптомов угрожающего разрыва матки** немедленно заканчивают роды путём кесарева сечения [8](https://ru.wikipedia.org/wiki/%D0%A0%D0%B0%D0%B7%D1%80%D1%8B%D0%B2_%D0%BC%D0%B0%D1%82%D0%BA%D0%B8). \n**При начавшемся и совершившемся разрыве** показана немедленная лапоротомия [8](https://ru.wikipedia.org/wiki/%D0%A0%D0%B0%D0%B7%D1%80%D1%8B%D0%B2_%D0%BC%D0%B0%D1%82%D0%BA%D0%B8). В большинстве случаев выполняют органосохраняющую операцию: плод и послед извлекают, обследуют стенки матки, разрывы зашивают [8](https://ru.wikipedia.org/wiki/%D0%A0%D0%B0%D0%B7%D1%80%D1%8B%D0%B2_%D0%BC%D0%B0%D1%82%D0%BA%D0%B8). 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