Uterine rupture is a tear of the uterus. This is uncommon but a very serious childbirth complication.

Female Reproductive Organs

© 2009 Nucleus Medical Art, Inc.


Uterine rupture occurs more often in women who have had prior surgery on their uterus. They may be a previous cesarean section delivery or other procedures such as fibroid removal .

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

The following factors increase your chance of developing a uterine rupture. If you have any of these risk factors, tell your doctor:

  • Previous uterine surgery, including cesarean section
  • More than five full-term pregnancies
  • Having an overdistended uterus (usually due to carrying more than one baby)
  • Use of labor-inducing drugs


If you experience any of these symptoms, do not assume it is due to uterine rupture. During delivery the healthcare team will monitor you and your baby to watch for problems such as this. Most uterine ruptures occur without symptoms, and are only discovered when surgery is performed for another reason. However, more serious uterine ruptures have the following symptoms:

  • Severe, localized pain
  • Abnormal fetal heart rate
  • Vaginal bleeding
  • Examination shows the baby is not as low in the birth canal as earlier in labor


The most recent studies show that fetal distress (an abnormal fetal heart rate) is the most reliable symptom indicating a uterine rupture. The obstetrician will urgently deliver the baby, usually by cesarean section. If the baby is not delivered as quickly as possible, it could suffer permanent brain damage and other problems due to lack of oxygen. Studies show that delivery within 17 minutes results in the fewest problems for the mother and the baby. During the delivery procedure, the doctor can diagnose and surgically repair the uterine rupture.


Often women who delivered a previous baby via cesarean section can attempt a vaginal delivery (VBAC). If you decide to deliver vaginally after a cesarean, you will need constant fetal monitoring and should therefore only attempt the delivery in a facility where emergency surgery is available. In the event of a serious uterine rupture, a physician will surgically repair your uterus after cesarean delivery, and you may require a blood transfusion if there was significant blood loss. Talk with your doctor about the best delivery plan for you.


Women with one previous low-transverse cesarean section have about a 1.5% rate of uterine rupture. Women with two or more prior cesarean sections increase their risk of uterine rupture to about 4%. If you have one or more risk factors for uterine rupture, be sure to develop a thorough birth and complication plan with your doctor.