Healthwise

Our Health Library information does not replace the advice of a doctor. Please be advised that this information is made available to assist our patients to learn more about their health. Our providers may not see and/or treat all topics found herein.

VBAC: Uterine Scar Rupture

Overview

The most rare yet most serious risk of vaginal birth after cesarean (VBAC) is that the scar on the uterus may break open (rupture) during labor. Women who have a low transverse cesarean scar have a lower risk of rupturing than women who have a vertical incision scar. About 5 out of 1,000 women (0.5%) with a low transverse scar have a uterine rupture during a trial of labor.footnote 1

A woman's risk of uterine rupture increases with:

  • Each additional uterine surgical scar.
  • Any uterine scar that reaches above the lower, thinner part of the uterus, such as a vertical (classical) scar.
  • The use of medicine to start (induce) labor. Some doctors avoid the use of any medicine to start a VBAC trial of labor. Other doctors are comfortable with the careful use of certain medicines to start labor.

In the rare event that a uterine scar ruptures, it can be dangerous to both the mother and her infant.

Depending on severity, a rupture can:

  • Be mild and harmless.
  • Often be repaired. If it is not repairable, the uterus is removed (hysterectomy).
  • Cause severe maternal bleeding and a decrease in oxygen to the baby.
  • Cause fetal brain damage or death.

References

Citations

  1. Guise JM, et al. (2010). Vaginal birth after cesarean: New insights. Evidence Report (Publication No. 10-E003). Rockville, MD: Agency for Healthcare Research and Quality.

Credits

Current as of: July 10, 2023

Author: Healthwise Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Due to the threat of the COVID-19 (Coronavirus), we are taking precautionary measures to protect our staff and patients. We are implementing a temporary NO VISITOR policy at this time. Only patients or patients and their guardians will be allowed into the office. Please note, this is not to inconvenience anyone! The virus is a very real threat and it is essential that we stay healthy in order to provide needed care for our patients. If you are sick, we ask that you CALL the office to speak with a nurse before you come in. The nurse will provide specific instructions for you. Please DO NOT enter the office if you are sick (upper respiratory symptoms, fever, cough, or flu like symptoms). We are closely monitoring the situation and will update you as circumstances change. Thank you for your understanding!!