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Vaginal Birth After Cesarean Delivery (cont.)

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:

Rupture requires immediate delivery of the baby by emergency cesarean.

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