Uterine Rupture

Uterine rupture in pregnancy is a rare occurrence, but when it happens it can be life-threatening for both mom and baby. A study conducted from 1976 to 2005 showed an overall rupture rate of 1 in 1,514 pregnancies, or 0.07%. Still, if a uterine rupture does occur, doctors have only 10–30 minutes to prevent fetal death.

A uterine rupture is a tear in the wall of the uterus, usually in the location of a previous c-section incision. There are different types of uterine ruptures. A complete rupture tears through all layers of the uterine wall, and the consequences are severe for mother and baby. The majority of uterine ruptures occur during labor, although they can also happen at any time during pregnancy.

Many healthcare providers encourage moms who have had a previous uterine surgery to try VBAC, vaginal birth after caesarean. However, in some cases this isn’t possible, and another c-section is necessary for birth.

Who’s at Risk for Uterine Rupture?

Thankfully, women who have never had a c-section, a previous rupture, or other uterine surgery are not at risk for this complication. Now, that’s not saying it isn’t possible for a woman to experience a uterine rupture. In most cases, however, the rupture occurs due to a previous uterine surgery, such as a c-section. In 90 percent of all cases, the rupture happens at the site of a scar from a previous c-section, usually occurring during labor when the scar is more likely to give way under the stress of the contractions.

Uterine Rupture Symptoms

Unfortunately, there are not very many specific symptoms of uterine rupture. Diagnosis can be extremely difficult, even for the best healthcare providers. What’s even more unfortunate is that due to the difficulty of diagnosing the problem, treatment is often delayed. The most common symptoms of a uterine rupture are:

  • Abdominal pain
  • Vaginal bleeding
  • High pulse rate
  • Signs of shock
  • Chest pain

Uterine Rupture Causes

There are only a few things that can cause a uterine rupture. The most common is a scar left from a previous c-section or uterine surgery (operations to remove fibroids, correct misshapen uterus, repair previous ruptures, etc.). Other causes can include:

  • Placenta previa
  • Placenta accreta
  • Multiple fetuses
  • Placental abruption
  • Macrosomia (big baby)
  • Trauma
  • Difficulty removing placenta after delivery

It is possible for an unscarred uterus to rupture, but thankfully this only happens in one in 15,000 pregnancies, and almost always during labor.

Uterine Rupture Treatment

If the baby has not been delivered, then an emergency c-section is scheduled immediately. Hopefully the damage to the uterus isn’t too severe and the bleeding can be controlled; otherwise a hysterectomy will be necessary. If there isn’t much damage to the uterus, and if bleeding can be kept under control, then doctors will do their best to repair the uterus. This process generally calls for a blood transfusion for the mother due to the amount of blood loss, and antibiotics are given to prevent infection.

Women who survive this experience tend to suffer from lightheadedness and weakness for the first few days. Getting plenty of rest, eating properly, drinking fluids, taking iron, and following all doctor’s orders is the best treatment once the mother is home.

[Page updated June 2014]