This occurs once in approximately every 1500 deliveries in the UK. This condition is much more common in parts of Africa where the incidence is approximately 1 in 100 deliveries.
Rupture may occur apparently spontaneously or it may result from trauma before or during labour.
Uterine scars are a risk factor for rupture.
- classical CS causes 2% rupture in subsequent pregnancies
- LSCS is associated with 0.2% rupture
- previous myomectomy or hysterotomy are associated with increased rupture rates
Risk factors for rupture, in the absence of uterine scars:
- cephalopelvic disproportion
- syntocinon augmentation of labour
Fetal mortality and maternal mortality:
- there is an approximate 5% maternal mortality and 30% fetal mortality associated with this condition
Note that a model attempting to identify risk of uterne rupture concluded that:
- factors that were available before or at admission for delivery cannot be used to predict accurately the relatively small proportion of women at term who will experience a uterine rupture during an attempted vaginal birth after cesarean delivery (1)
- 1. Grobman WA et al ; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network.Prediction of uterine rupture associated with attempted vaginal birth after cesarean delivery. Am J Obstet Gynecol. 2008 Jul;199(1):30.e1-5
Last reviewed 01/2018