Who is at risk for uterine rupture

Over the 10 years, there were , deliveries with 39 cases of uterine rupture : 18 complete and 21 incomplete, or dehiscence. Uterine dehiscence did not have any fetal deaths. Uterine rupture is a scary topic for providers. It can often be hard for women to be able to find a supportive provider for VBAC due to this fear. As with the uterine window, a repeat Cesarean would need to be performed in order to confirm uterine dehiscence.

Historically, providers would explore the uterus more during a Cesarean to see if there were any other tears, but currently that practice is not likely to happen.

When the scar tissue starts to separate, fluid can enter the body cavity and leak into the membrane that separates the organs from the cavity wall. Uterine dehiscence was associated with minimal maternal and perinatal morbidity. Statistically, uterine rupture happens in 0. That equals one in Now, as will all things, probability should be considered and assessed. The two studies of women delivering at term that reported perinatal death rates report that To put it differently, of the women who had a uterine rupture, one in 16 resulted in infant death.

For comparison, the average neonatal mortality rate for the U. There are many things you can do to minimize the chances of uterine rupture. Women who receive good prenatal care, whose care providers are trained and experienced with VBAC, and who labor in a facility that is equipped to provide immediate medical care usually have good outcomes.

To date there have been no reports of maternal deaths due to uterine rupture. According to the National Institutes of Health Consensus Development Report on VBAC , while rare for both, laboring for a VBAC and elective repeat cesarean, current research shows that maternal mortality is significantly increased for elective repeat cesarean, Although it is not possible to predict which women are likely to experience a uterine rupture while laboring for a VBAC, recent studies suggest that the risk for uterine rupture is somewhat higher when:.

Current US health law and medical-ethical guidelines give childbearing women who once gave birth by cesarean the option of laboring for a VBAC or scheduling an elective repeat cesarean. Physicians should give women comprehensive information about the benefits and risks of VBAC and elective repeat cesarean, but ultimately the decision should be made by the patient.

Critically examines the increasing use of cesarean deliveries for childbirth, the risks, outcomes, and other issues women need to consider to make an informed decision whether to have a natural birth or a cesarean. Powered by WordPress. Designed by. This website provides childbearing women and maternity care professionals evidence-based information, resources, and support for VBAC and cesarean prevention. Translate site:. Mothers-to-be are encouraged to obtain relevant information, to discuss their options with their maternity care providers and to make safe and informed choices.

We welcome all inquires, but will not suggest any medical course of action. This site is privately funded. No advertisements are accepted. Induction — particularly with prostaglandins or augmentation of labour. Obstruction of labour — this is an important risk factor to consider in developing countries.

Multiple pregnancy. Clinical Features The initial clinical features of uterine rupture are non-specific , which makes diagnosis and prompt management difficult.

Fetal monitoring may reveal fetal distress or absent heart sounds. Placenta praevia — typically causes a painless vaginal bleeding. Vasa praevia — characterised by a triad of ruptured membranes, painless vaginal bleeding, and fetal bradycardia. Investigations In women at risk of uterine rupture, intrapartum monitoring with cardiotocography is vital. Management Uterine rupture is an obstetric emergency. Give cross-matched blood as soon as it is available, until then give up to 2L of warmed crystalloid and L of warmed colloids, then transfuse O negative or uncross matched group specific blood.

There are two main types: Incomplete — where the peritoneum overlying the uterus is intact. In this case, the uterine contents remain within the uterus.

Complete - the peritoneum is also torn, and the uterine contents can escape into the peritoneal cavity. Found an error? Is our article missing some key information? Make the changes yourself here! Don't ask me again. This website uses cookies. Manage consent. Getty Images. Serious but rare, a rupture will prompt an immediate C-section followed by surgical repair of your uterus.

Back to Top. In This Article. What is uterine rupture? Continue Reading Below. Recommended Reading. Having a C-Section Cesarean Section. View Sources. Merck Manual, Uterine Rupture , January