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Summary

Uterine rupture is uncommon, but is a serious complication of a trial of labor after a prior cesarean section (TOLAC). There are several risk factors that can increase the risk of uterine rupture including certain types of prior uterine incision, a previous myomectomy, or a history of dehiscence or rupture. The most common sign of uterine rupture is a change in fetal heart rate including variable decelerations or prolonged decelerations. Prompt mobilization of a multidisciplinary team is required for uterine rupture including anesthesia, pediatrics, blood bank, and an urgent delivery. Depending on the size and location of the uterine rupture, primary repair may be feasible, but a more complex repair may be required if the rupture extends into the broad ligament or involves surrounding viscera.

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Case 57 - A 25-Year-Old at 39 Weeks’ Gestation with Abdominal Pain, Vaginal Bleeding, and Worsening Fetal Heart Rate Tracing during TOLAC

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Case 57 - A 25-Year-Old at 39 Weeks’ Gestation with Abdominal Pain, Vaginal Bleeding, and Worsening Fetal Heart Rate Tracing during TOLAC

Summary