(Spontaneous Uterine Rupture; Uterine Scar Disruption)
Uterine rupture is a tear of the uterus. This is uncommon but a very serious childbirth complication.
Female Reproductive Organs
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.
The American College of Obstetricians and Gynecologists
The National Women’s Health Information Center
Vaginal Birth After Cesarean Section
The Canadian Women's Health Network
The Society of Obstetricians and Gynaecologists of Canada
Jukelevics N. What about uterine scar ruptures? Vbac.com website. Available at: http://www.vbac.com/uterine.html . Accessed August 9, 2005.
Uterine rupture. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/20020901/823.html . Accessed August 8, 2005.
Last reviewed November 2008 by ]]>Jeff Andrews, MD, FRCSC, FACOG]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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