A uterine rupture occurs when there is tearing within the uterus, usually during labor. It can result in the fetus entering the mother's abdominal cavity. This catastrophic complication can result in the death of infant and mother.
The risk of a uterine rupture increases during a vaginal birth after cesarean section (VBAC). VBACs are not uncommon. The American Academy of Family Physicians reports over 100,000 VBACs throughout the United States annually.
What are the common causes of uterine rupture? One prior cesarean generally results in a 0.6 percent risk of the complication while the risk for a patient with two or more prior cesareans more than triples to 3.9 percent.
Some studies have found that use of Oxytocin (Pitocin) to encourage labor can also increase the risk of a uterine rupture. In one study, researchers reported 77 percent of patients who reported ruptures were using this medication. Induction of labor is connected to the complication -- regardless of the form of induction used.
How does a physician diagnose this complication? Fetal distress is the most reliable way to promptly recognize uterine rupture. Shoulder dystocia is also an indicator of the complication. This is because the infant's body may be moving in response to the rupture in such a manner that results in the baby becoming lodged within the birth canal.
The medical community expects physicians to manage this complication. In most cases, the medical expectation for a fetus with fetal distress is an urgent delivery. This often results in a cesarean section. A failure to properly intervene can result in serious complications. Complications can result in the need for a hysterectomy for the mother, brain damage for the infant and, as noted above, the death of both the infant and the mother.