Vaginal Birth After Cesarean Delivery (cont.)

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Medical Author:

Harish M Sehdev, MD

Medical Editor:

Bryan D Cowan, MD

Medical Editor:

Mary L Windle, PharmD

Medical Editor:

Lee P Shulman, MD

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Risk of Uterine Rupture

In the last 20 years, studies have shown that women who have had a prior cesarean delivery with a low transverse incision may safely and successfully go through labor and have a vaginal delivery in later pregnancies, depending on the reason for the cesarean delivery. The same, however, cannot be said of women who have had vertical incisions on the uterus.

Women with a prior history of more than one low transverse cesarean delivery are at slightly increased risk for uterine rupture. This risk increases significantly when the woman has had three cesarean deliveries.
In about 10% of women with vertical uterine incisions, the uterus will rupture (break open).
The uterus may rupture even before labor begins in up to 50% of these women.
Uterine rupture can be dangerous to the fetus even if delivery is accomplished immediately after a uterine rupture.

Diagnosing a uterine rupture can be difficult. Signs of a rupture include the following: