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Uterine Rupture Risk in Pregnancy

Risk assessment, prevention, and management of uterine rupture during pregnancy or labor, especially in women with a previous cesarean section or uterine surgery.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Uterine Rupture Risk in Pregnancy?

Uterine rupture is a complete or incomplete tear of the uterine wall during pregnancy or labor that may extend through the myometrium and serosa, leading to massive maternal hemorrhage and severe fetal compromise.

The most important risk factor is a uterine scar from previous cesarean section, especially classical (vertical) incision, multiple cesarean deliveries, prior myomectomy entering the cavity, or short interpregnancy interval.

Risk-based delivery planning involves selecting candidates for trial of labor after cesarean (TOLAC), avoiding uterotonic agents in scarred uteri, careful intrapartum monitoring, and immediate emergency cesarean and uterine repair or hysterectomy when rupture is suspected.

Symptoms

Sudden severe abdominal pain in labor that breaks through epidural analgesia
Abnormal cardiotocography pattern with prolonged decelerations or fetal bradycardia
Loss of station of the presenting part
Vaginal bleeding or hematuria
Maternal tachycardia, hypotension, and signs of hypovolemic shock
Loss of uterine contraction tone after a previously regular pattern

Risk Factors

Previous cesarean section, especially classical incision or two or more low transverse incisions
Previous myomectomy with cavity entry
Short interpregnancy interval (less than 18 months)
Inappropriate use of oxytocin or prostaglandins in a scarred uterus
Grand multiparity, fetal macrosomia, malpresentation, and obstructed labor

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Pregnancy with prior cesarean or uterine surgery — preconceptional or early antenatal counseling on delivery options
  • Sudden severe abdominal pain or vaginal bleeding in labor — emergency transfer to a hospital with cesarean capability
  • Decreased fetal movements or abnormal fetal heart rate in late pregnancy
  • Postpartum severe abdominal pain or unstable vital signs

Treatment Methods

01
Risk stratification, individualized decision on TOLAC versus elective repeat cesarean section
02
Continuous electronic fetal monitoring during trial of labor and avoidance of high-dose oxytocin or prostaglandins on scarred uterus
03
Immediate emergency laparotomy and cesarean delivery when rupture is suspected
04
Uterine repair or peripartum hysterectomy depending on the extent of injury and bleeding control
05
Aggressive resuscitation with massive transfusion protocol and postoperative intensive care monitoring

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.