Doctor insights on:
Causes Of Uterine Rupture
What can cause a uterine rupture? Not pregnant no prior sections ; natural vaginal births 7/9 yrs ago. Ultrasound shows bleed. Info and on profile
Adenomyosis: One consideration is an underlying disease causing weakness of the uterine muscle. One such common disease is adenomyosis. Adenomyosis is essentially endometriosis of the underlying uterine muscle where the endometrial cells infiltrate and weaken the uterine muscle. MRI is the best imaging test to diagnosis it and check for other abnormalities which could be the cause.
Muscle tears: The uterus is a muscle that can rupture, or tear. Most commonly, uterine rupture occurs at the site of scar formation. For example, after a woman has a cesarean section (in which the uterus is opened and stitched back together), a scar will form. This scar in the uterus could tear apart during a subsequent labor, causing uterine rupture.See 1 more doctor answer
YES: Uterine rupture can lead to catastrophic hemorrhage & death. It is a risk of pregnancy anytime you've had previous uterine surgery (c-sections, myomectomy), and is something you really need to discuss with your physician if you think you're at risk. If you have risk factors, please no home delivery.See 1 more doctor answer
See long answer: Uterine rupture is a rare event occurring typically with a pregnant uterus often during labor. The uterus literally tears or ruptures. This is both a maternal & fetal emergency. Uterine rupture is more common to occur with a uterus that has been previously scarred, for example a prior c-section or prior fibroid removal. Uterine rupture is the most worrisome complication for women with prior c-s.
After C-section: The uterus is a muscle that can rupture, or tear. Most commonly, uterine rupture occurs at the site of scar formation. For example, after a woman has a cesarean section (in which the uterus is opened and stitched back together), a scar will form. This scar in the uterus could tear apart during a subsequent labor, increasing the chance of uterine rupture.
Uterine rupture: Uterine rupture is a complication of (tolac) trial of labor after a cesarean section. It refers to the opening of the uterine scar during the labor process. It is a rare event that occurs in less than 2% of cases. If it does occur it can be catastrophic for the mother and baby.See 1 more doctor answer
Yes: Via a cesarian section, which would be the safest mode of delivery under these circumstances. The circumstances surrounding the uterine rupture will help to determine if the patient is a safe candidate for conceiving again several years later. Ck with your OB before trying to conceive again, please.
What happens if a woman is at risk for uterine rupture as all repeat c sections are but uterine rupture is very rare?
Weigh the risk...: The risk of Uterine Rupture is low:. 7% -. 9% in women who elect to have a vaginal birth after a prior c/section (VBAC). However, a uterine rupture can result brain damage to the baby or in the death of the mother, baby or both. If a labor and delivery unit allowed 1000 women to VBAC, this would result in 7 ruptures. Some patients/doctors are willing to take this risk, some are not.
Very rarely: It is a very rare occurence.Get a more detailed answer ›
Discuss with OB: I think you are asking if a vaginal delivery is safe after having had a prior c-section. The clinical thinking on this has changed in the past several years, and you should certainly discuss this at some length with the doctor who is going to delivery the baby. Have a good delivery and a great baby.See 1 more doctor answer
Any risk factors?: You shouldn't worry unless you have risk factors for rupture. This includes any uterine surgery, c-sections, types of incisions in the uterus, malformations of the uterus, large fibroid tumors, or prolonged and/or excessive uterine contractions in labor (to name a few). Your OB will keep you safe in labor & you should discuss any risk factors for rupture with your OB & deliver in a safe hospital.See 1 more doctor answer
I have been doing some research on vbac. If the percentage of uterine rupture is so low, why does it seem like doctors still do not prefer to perform them?
Risk: Many doctors still do vbac with proper council. The risk of uterine rupture is about 1% for spont. Labor, 2% for augmented labor and 4% for induced labor. This is low. The concern is the consequence of uterine rupture. 50% catastrophic results, loss of mother, loss of baby or lifetime neurological injury to baby! Many but not all couples are willing to accept those risks.See 3 more doctor answers
How long has a patient that has a uterine rupture during labor typically been laboring before the rupture occurs?
Usually hours: Uterine rupture occurs in about 1% of women without prior uterine surgery, e.g. C-section and in 2% with previous low segment transverse c-section. When it occurs, it is generally after several hours to days of labor, but can occur earlier. If you have had previous uterine surgery, you should present to the labor unit as soon as you feel you are in labor. Please ask you OB doc for specifics.
Suturing: Best treatment is to suture it. There is still a chance to reccur after awhile.
How common is uterine rupture and is it always fatal?? I've had 1 vertical c-section and 2 horizontal, I'm not worried.
2%: The uterine rupture rate is about 1% in women with no uterine scars and 2% in those with previous uterine surgery and slightly higher in multiple surgeries. It is rarely fatal to the mother, but can be for the fetus. The type of incision in the uterus is the critical factor, not the direction of the scar on the abdomen.
What are the statistics on fetal demise and permanent damage to baby with uterine rupture/vbac? Not risk %. Actual statistics
1/700-1/1, 000.: Great question - the numbers are approximately one order of magnitude greater with trial of labor after a cesarean as compared to a repeat prelabor cesarean delivery: 1/1, 000 vs. 1/10, 000. In other words, rarely is the fetus compromised/dies, but repeat cesarean is clearly safer for the fetus. Talk to your OB to decide on the best plan for you, taking into account how many more babies you want.
I'm being advised to terminate due to risk of uterine rupture what are your thoughts? The ultrasound shows a small peri sac bleed on the fundal aspect of the sac
Why???: I am sorry...what is the rationale? If there is no fetal heart beat...understandable. Uterine rupture probably will not occur because of a pregnancy. There is no reason to undergo a termination based on the history given. If your doctor is concerned about said pregnancy....see somebody else. You can carry a pregnancy close to term. Chance of uterine rupture is less than 1%....