[Accessed April 2020], Medscape. 1999 Nov. 87(1):39-45. * Defined as > 6 contractions during 2 consecutive 10-minute periods of observation. Had the uterine scar status for this patient been known in advance, it would have represented a contraindication to TOLAC. , A multi-country population-based study reported the overall prevalence of uterine ruptures was 3.3 per 10,000 deliveries, 22 per 10,000 in women with previous cesarean section and 0.6 per 10,000 (in women without previous cesarean section.  Additionally, they found that patients with twins were less likely to attempt a TOLAC (OR, 0.3; 95% CI 0.2-.04), but no more likely to have a VBAC failure (OR, 1.1; 95% CI, 0.8-1.6), or major maternal morbidity (OR, 1.6; 95% CI, 0.7-3.7). 2006 Oct. 19(10):639-43. Lydon-Rochelle et al reported a 15.6-fold increased risk for uterine rupture (95% CI, 8.1-30) when prostaglandins were used in gravidas who underwent a TOLAC.  In a study of 205 patients who underwent a TOL after 1 previous cesarean delivery, Kayani and Alfirevic noted that all 4 of their cases of uterine ruptures occurred in women with no previous vaginal delivery. [Medline]. 1949. Zelop CM, Shipp TD, Repke JT, Cohen A, Lieberman E. Outcomes of trial of labor following previous cesarean delivery among women with fetuses weighing >4000 g. Am J Obstet Gynecol. Rageth JC, Juzi C, Grossenbacher H. Delivery after previous cesarean: a risk evaluation. Several complications can occur during childbirth, some of which pose risks to the mother and the baby. Am J Obstet Gynecol. The peer-reviewed literature was searched using the PubMed, Medline, and Cochrane databases for all relevant articles published in the English language. Ford AA, Bateman BT, Simpson LL. Read on if you have questions about the signs and length of labor. The baby is delivered by emergency c-section, and the uterus is repaired.  Schrinsky and Benson found that 7 of 22 women (32%) who had unscarred uterine rupture had a parity of greater than 4. 1999 Oct. 181(4):882-6. Huang WH, Nakashima DK, Rumney PJ, Keegan KA Jr, Chan K. Interdelivery interval and the success of vaginal birth after cesarean delivery. BJOG. How common are they, and what is their distribution among subtypes?. J Reprod Med. 2019. 2001 May. Meta-analysis of pooled data from 25 studies in the peer-reviewed medical literature published from 1976-2012 indicated an overall incidence of pregnancy-related uterine rupture of 1 per 1,416 pregnancies (0.07%). 2000 Nov. 183(5):1176-9. Vaginal birth after cesarean delivery in twin gestations: a large, nationwide sample of deliveries. Healthline Media does not provide medical advice, diagnosis, or treatment. You may feel weak and lightheaded, and at first you shouldn't try to get out of bed on your own. [Medline]. 2004 Dec. 111(12):1394-9. In a small case series, Bujold et al found no statistically significant difference among the uterine rupture rates of 1.1% for spontaneous labor, 1.2% for induction by amniotomy with or without oxytocin, and 1.6% for induction by transcervical Foley catheter (P =0.81). Obstet Gynecol. [Medline]. Please whitelist our site to get all the best deals and offers from our partners. : But yeah, I don't believe women will have the ability to get pregnant during the Tribulations. 2004 Jul. Am J Obstet Gynecol.  Blanchette et al reported that hysterectomy was necessary in 17% of women (2 of 12) who developed uterine rupture. Pregnant women face a several-fold higher risk of venous thromboembolism, 1 myocardial infarction, 2 and stroke 3 than nonpregnant women of childbearing age. 199(1):32.e1-5. . Other complications that may occur with PROM include placental abruption (early detachment of the placenta from the uterus), compression of the umbilical cord, cesarean birth, and postpartum (after delivery) infection. 175(1):194-8. Although the study was underpowered to detect small differences, the particular type of prostaglandin administered did not appear to significantly affect the uterine rupture rate (52 patients received misoprostol; 111, dinoprostone; 60, PGE2 gel; and 4, combined prostaglandins). A uterine rupture occurs when a weakened spot on your uterine wall — almost always the site of a previous uterine surgery such as a C-section or fibroid removal — tears due to the strain put on it during labor and delivery. N Engl J Med. Uterine configuration may be normal or may involve a congenital uterine anomaly. Other possible risk factors for uterine rupture include: Trauma to the uterus, from such things as a car accident or a procedure such as external cephalic version or a difficult forceps delivery, may also cause a uterine rupture, as can a difficult manual removal of the placenta. For spontaneous labor, uterine ruptures occurred in 0.5% of gravidas delivering at or before 40 weeks compared with 1.0% for those delivering after 40 weeks (P = 0.2).