Uterine rupture: what it is and how likely
About 7 in 1,000 women attempting labor.
Uterine rupture means the old scar gives way during labor. It is an emergency requiring immediate delivery. Among 17,898 women attempting labor after a prior cesarean, rupture occurred in 124, or 0.7%.
The risk is not the same for everyone. It is lowest in spontaneous labor and higher when labor is induced, particularly with prostaglandin medications. Twelve babies in that study suffered brain injury from lack of oxygen, and 7 of those followed a rupture. Across all term trials of labor in the study, that injury occurred at a rate of about 0.46 per 1,000.
Put it in proportionRoughly 993 of every 1,000 women who attempt labor after one cesarean will not have a rupture. Roughly 7 will. Both parts of that sentence should be said out loud.
Where this comes from:
269. Landon MB, Hauth JC, Leveno KJ, Spong CY, Leindecker S, Varner MW, et al. Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery. N Engl J Med. 2004;351(25):2581-2589.
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