On 2014 Apr 02, Gwinyai Masukume commented:

Getahun and colleagues present a case of a patient with uterine rupture (1). Abnormalities of the fetal heart rate such as tachycardia, recurrent variable decelerations, late decelerations or prolonged decelerations appear to be the earliest and most sensitive indicator of uterine rupture (2). Mentioning this information in their broader discussion of uterine rupture may have been essential.

Although the clinical presentation of uterine rupture depends on for example, the site, size and duration of the rupture it may also have been worthwhile pointing out in their article that hematuria may occur with uterine rupture (3).

References

(1) Getahun BS, Yeshi MM, Roberts DJ. Case records of the Massachusetts General Hospital: Case 34-2012: a 27-year-old woman in Ethiopia with severe pain, bleeding, and shock during labor. N Engl J Med, 2012 367(19):1839-45.

(2) Goodwin TM, Montoro MM, Murdespach L, Paulson R, Roy S (eds), 2010, Management of Common Problems in Obstetrics and Gynecology, 5th edition, Wiley-Blackwell, page 55.

(3) Baker PN, Kenny LC (eds), 2011, Obstetrics by Ten Teachers, 19th editon, Hodder-Arnold, London, page 251.

On 2014 Apr 02, Gwinyai Masukume commented:

Getahun and colleagues present a case of a patient with uterine rupture (1). Abnormalities of the fetal heart rate such as tachycardia, recurrent variable decelerations, late decelerations or prolonged decelerations appear to be the earliest and most sensitive indicator of uterine rupture (2). Mentioning this information in their broader discussion of uterine rupture may have been essential.

Although the clinical presentation of uterine rupture depends on for example, the site, size and duration of the rupture it may also have been worthwhile pointing out in their article that hematuria may occur with uterine rupture (3).

References

(1) Getahun BS, Yeshi MM, Roberts DJ. Case records of the Massachusetts General Hospital: Case 34-2012: a 27-year-old woman in Ethiopia with severe pain, bleeding, and shock during labor. N Engl J Med, 2012 367(19):1839-45.

(2) Goodwin TM, Montoro MM, Murdespach L, Paulson R, Roy S (eds), 2010, Management of Common Problems in Obstetrics and Gynecology, 5th edition, Wiley-Blackwell, page 55.

(3) Baker PN, Kenny LC (eds), 2011, Obstetrics by Ten Teachers, 19th editon, Hodder-Arnold, London, page 251.