Although uterine ruptures are rare, they are more common in women who have had previous C-sections. The risks for uterine rupture and C-section increases by the number of C-sections a woman has had. 90 percent of uterine ruptures occur at the site of a previous C-section and almost always occur during labor or childbirth. For this reason, many labor and delivery units won't perform vaginal births if there’s a history of C-sections. If a uterine rupture occurs, the results for both mother and baby can be fatal.
What Is a Uterine Rupture?
A uterine rupture is the result of a tear in the uterine wall, commonly at the site of a previous C-section scar. A complete uterine rupture occurs when the tear includes all of the layers of the uterine wall. The risk for uterine rupture increases for women who have had previous uterine surgeries, including C-sections, and previous uterine ruptures. Most often, the rupture will occur during labor, but in rare cases, it can occur during pregnancy.
What Causes a Uterine Rupture?
A uterine rupture and C-section often go hand-in-hand because the scar from previous surgeries and C-sections becomes weakened during the stress of contractions or as the uterus stretches. A uterine rupture is more likely to occur in women who have had a classical C-section, or a vertical C-section. For those with a horizontal C-section, the risk for uterine rupture is less than one percent. Most often, a scheduled C-section will occur to prevent a uterine rupture during labor, which is especially common for those with a previous classical C-section.
While the risk for a uterine rupture is rare, usually only 1 in 15,000 pregnancies, the risks for a rupture do increase for women who have had five or more children. If the placenta is implanted too deeply into the uterine wall or for those that have an overdistended uterus, usually due to twins, the risk for uterine rupture increases. Extremely frequent or forceful contractions can cause the uterus to rupture as well. Trauma to the uterus and prolonged labor can result in a rupture of the uterus.
How Is a Uterine Rupture Treated?
If a uterine rupture should occur during labor or pregnancy, an emergency C-section is conducted. In cases of extensive uterine damage or uncontrollable bleeding, the mother will need a hysterectomy. If other complications don’t occur, the uterus can be repaired and IV antibiotics are given to prevent infection. Because severe blood loss normally occurs during a uterine rupture, the mother may require a blood transfusion as well.
Recovery from a uterine rupture involves resting after surgery. A short hospitalization is generally required to monitor the mother after surgery. Once home, it’s essential to rest, maintain nutrition and drink plenty of fluids. Follow up appointments are needed to ensure proper healing.
"Uterine Rupture in Pregnancy" EMedicine
"Uterine Rupture" BabyCenter
"Uterine Rupture" PregnancyToday