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What is a uterine rupture and does it pose a danger to mother or baby?

A uterine rupture is a tear in the wall of the uterus. Accounting for ninety percent of all cases, uterine rupture is most common among mothers who have had a previous cesarean section.

Scar tissue

During contractions the extra stress can cause the previous incision scar tissue to expand and stretch, and can eventually stretch thin enough to give way. However, there are cases of uterine ruptures occurring in mothers who have never had a cesarean, and are caused by weak uterine muscles after several pregnancies, use of forceps in a vaginal birth, or a prior surgery on the uterus.

Some uterine ruptures are only partial, but in the case of a complete rupture the tear goes through all the layers of the uterine wall. While uterine ruptures are rare, they can pose a serious complication for both mother and baby, and will require immediate surgical intervention.

For women attempting vaginal birth after cesarean (VBAC), they will need constant monitoring as they are at a much higher risk for uterine rupture.

A uterine rupture can come on suddenly during labor or delivery. Symptoms include:

  • Abnormality in the baby’s heart rate
  • Abdominal pain
  • Vaginal bleeding
  • A rapid pulse
  • Contractions that slow down or become less intense
  • Tenderness or pain in the abdomen

Immediate attention for uterine ruptures

In the case of a full uterine scar rupture, immediate surgical intervention is necessary.  Without surgery the baby and/or placenta can push through the uterine wall into the abdominal cavity.  This puts the woman at an increased risk of hemorrhage.  Additionally, the baby can lose access to oxygen and increases the risk for neurological disorders such as cerebral palsy.

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