Uterine Rupture

What is uterine rupture?

A uterine rupture is a serious complication where your uterus tears or breaks open. It’s most common in people who’ve had a previous C-section delivery and then try for a vaginal delivery, or vaginal birth after cesarean (VBAC).

Your uterus is a muscular organ that can grow to support a developing fetus. It’s made of several layers of tissue. In a uterine rupture, these layers tear open. It’s most common for uterine rupture to occur along the scar line of a prior C-section incision. In a C-section delivery, your obstetrician cuts into your uterus to deliver your baby, leaving a scar. Ideally, this scar stays put and is strong enough to withstand the pressure of future pregnancies and labor. However, with a uterine rupture, this scar rips open.

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A uterine rupture can be complete or incomplete:

• Complete uterine rupture: The tear goes through all three layers of your uterine wall. This is very serious and requires immediate treatment.
• Incomplete uterine rupture: The tear doesn’t go through all three layers of your uterine wall.

Most uterine ruptures occur when a pregnant person is in labor, but it can happen during pregnancy. There are cases of uterine rupture in people who aren’t pregnant, but this is rare.

What happens when your uterus ruptures?

Uterine rupture is considered a medical emergency as it can have life-threatening consequences for both you and the fetus. It essentially leaves a hole in your uterus and abdomen. This can be very dangerous and cause severe blood loss. When your uterus ruptures, the fetus is left without the protection of your uterus. It can cause the fetus’s heart rate to slow down and leave it without oxygen. Without oxygen, the fetus is at risk for brain damage or suffocation. Pregnancy care providers must act quickly to remove your baby and repair your uterus.

How common is a ruptured uterus?

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Uterine rupture is rare. In people who’ve had one cesarean delivery, it happens in about 1 in 300 deliveries. Among people who’ve had more than one C-section, uterine rupture is more common, affecting up to 9 in 300 deliveries.

Who is most at risk for uterine rupture?

Uterine rupture is most likely to occur along the scar line in people who attempt a vaginal delivery after having a previous C-section delivery. Your risk for uterine rupture increases each time you have a C-section delivery.

Other risk factors include:

• History of uterine surgery.
• Previous uterine rupture.
• Uterine trauma.
• Congenital uterine anomalies such as septate uterus or bicornuate uterus.
• Your uterus is stretched, such as when you’re pregnant with multiples or have too much amniotic fluid.
• Your baby is breech and requires manual turning before delivery (external cephalic version).
• Prolonged labor.

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