Uterine Rupture

ByJulie S. Moldenhauer, MD, Children's Hospital of Philadelphia
Reviewed/Revised Jan 2024
VIEW PROFESSIONAL VERSION

Uterine rupture is a tearing open of the uterus in late pregnancy or during labor, which usually occurs in women who had prior uterine surgery (such as prior cesarean delivery). Uterine rupture may result in the fetus floating in the abdomen.

    Rupture of the uterus is very rare. It is an emergency requiring immediate treatment.

    The uterus can rupture before or during labor.

    The following increase the risk of uterine rupture:

    • Women have had a previous cesarean delivery, especially if labor is started with medications (induced) instead of occurring spontaneously.

    • Women have had surgery on the uterus.

    • The uterus is stretched too much (for example, by too much amniotic fluid in the uterus or by several fetuses).

    • The fetus is in the wrong position for delivery and has to be turned.

    Rupture causes severe, constant pain in a pregnant woman's abdomen and an abnormally slow heart rate in the fetus.

    To confirm the diagnosis of a ruptured uterus, doctors may make an incision in the abdomen so that they can directly view the uterus. This procedure is called a laparotomy.

    The fetus must be delivered by cesarean immediately. The uterus is then repaired surgically. Sometimes removal of the uterus (hysterectomy) is necessary.

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