Uterine rupture is when your uterine wall tears open. It’s more common in people who try a vaginal delivery after having had a cesarean delivery. It’s a rare but life-threatening complication that requires immediate treatment.
A uterine rupture is a serious complication where your uterus tears or breaks open. It’s most common in people who’ve had a previous C-section delivery and then try for a vaginal delivery, or vaginal birth after cesarean (VBAC).
Your uterus is a muscular organ that can grow to support a developing fetus. It’s made of several layers of tissue. In a uterine rupture, these layers tear open. It’s most common for uterine rupture to occur along the scar line of a prior C-section incision. In a C-section delivery, your obstetrician cuts into your uterus to deliver your baby, leaving a scar. Ideally, this scar stays put and is strong enough to withstand the pressure of future pregnancies and labor. However, with a uterine rupture, this scar rips open.
A uterine rupture can be complete or incomplete:
Most uterine ruptures occur when a pregnant person is in labor, but it can happen during pregnancy. There are cases of uterine rupture in people who aren’t pregnant, but this is rare.
Uterine rupture is considered a medical emergency as it can have life-threatening consequences for both you and the fetus. It essentially leaves a hole in your uterus and abdomen. This can be very dangerous and cause severe blood loss. When your uterus ruptures, the fetus is left without the protection of your uterus. It can cause the fetus’s heart rate to slow down and leave it without oxygen. Without oxygen, the fetus is at risk for brain damage or suffocation. Pregnancy care providers must act quickly to remove your baby and repair your uterus.
Uterine rupture is rare. In people who’ve had one cesarean delivery, it happens in about 1 in 300 deliveries. Among people who’ve had more than one C-section, uterine rupture is more common, affecting up to 9 in 300 deliveries.
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Uterine rupture is most likely to occur along the scar line in people who attempt a vaginal delivery after having a previous C-section delivery. Your risk for uterine rupture increases each time you have a C-section delivery.
Other risk factors include:
You may not notice any signs of uterine rupture. Your pregnancy care provider will look for symptoms of complications during delivery and take action if they suspect something is wrong.
Symptoms of uterine rupture could include:
If your provider knows you’re at risk for uterine rupture, they can take precautions before delivery. It’s important to share your complete medical history with your provider for this reason.
Most uterine ruptures occur at the site of a previous C-section scar during labor in a subsequent vaginal delivery. This is because the pressure and stress of contractions weaken the scar tissue, causing it to tear open. Once your uterus ruptures, the fetus has nowhere to go but into your abdomen.
If you’ve had a C-section, this puts you at higher risk for a uterine rupture. Your risk is slightly lower if your surgeon made a low-transverse uterine incision as compared to a vertical incision. However, other surgeries, such as surgery to fix a uterine anomaly, also put you at risk. Your pregnancy care provider may automatically schedule you for a C-section if they feel you’re at high risk for a uterine rupture to avoid potential complications.
Just because you’ve had a C-section doesn’t mean you can’t have a vaginal delivery. Be sure to discuss your previous deliveries with your provider so they can evaluate if you’re a good candidate for VBAC. In some cases, VBAC is too risky and your provider will recommend a C-section to avoid uterine rupture.
Not everyone feels a uterine rupture. If you do, you may feel like your abdomen is ripping open or you may feel a sudden surge of pressure. You may also feel symptoms of low blood pressure or rapid heart rate such as dizziness and shortness of breath.
Yes, uterine rupture can cause death. The rate of morbidity for the birth parent is less than 1%.
Yes. The rate of morbidity for the fetus is slightly higher than that of the birth parent (6%). Providers must act quickly to deliver the baby and provide life-saving treatment.
Diagnosis can happen during labor and delivery when your pregnancy care provider notices:
Pregnancy care providers confirm a uterine rupture by making an incision (cut) in your abdomen so they can see if your uterus has torn. If they confirm a uterine rupture, they’ll perform surgery to remove your baby as quickly and safely as possible.
If your uterus ruptures, your provider will deliver your baby right away. Then, they’ll repair your uterus with surgery. Sometimes, a hysterectomy (removing your uterus) is necessary if you’re losing a lot of blood. Healthcare providers must pull your baby from your abdomen quickly and be prepared to administer emergency care to both of you.
You can expect at least four to six weeks to recover from a ruptured uterus. It’s important to get lots of rest and follow your provider’s instructions on what to avoid until you’ve healed. Things your provider may ask you to avoid during your recovery include:
Uterine rupture can cause life-threatening complications. With quick treatment, there’s less risk of serious complications.
Complications for the fetus:
Complications for you:
You can reduce your risk by sharing your complete medical history with your provider and discussing risk factors for uterine rupture. Knowing that you’re at risk for uterine rupture helps your provider make preparations to prevent it.
Since your risk of uterine rupture is higher if you’ve had cesarean deliveries, your provider may decide it’s safer to schedule a C-section. This prevents you from going into labor and placing additional pressure on your uterus.
Yes, many people have subsequent pregnancies and deliveries after a uterine rupture. You typically will require a C-section delivery if you’ve had a previous uterine rupture.
A placental abruption is when the placenta separates from your uterus before delivery. In a placental abruption, your uterine wall doesn’t rip or tear. It’s similar to uterine rupture in that it can cause severe complications for you and your baby. Certain risk factors, like uterine trauma and expecting multiples, are common in both conditions. They also share some of the same symptoms like abdominal pain and vaginal bleeding.
A note from Cleveland Clinic
Uterine rupture is a rare but serious complication that occurs most often in people who attempt a vaginal delivery after having had a C-section or other surgery on their uterus. It’s important to discuss your medical history with your pregnancy care provider so they can make the best decision on how to proceed with your delivery. It’s possible to have a vaginal birth after a previous cesarean (VBAC) if certain criteria are met. Talk to your provider about your options for delivery and if you’re at risk for uterine rupture.
Last reviewed by a Cleveland Clinic medical professional on 11/30/2022.
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