Alert

Updates


As the COVID-19 situation has evolved, our visitor policy is evolving as well. Get full details.

For the most current information, please visit our Coronavirus resource pages.

VBAC: Uterine Scar Rupture

Topic Overview

The most rare yet most serious risk of vaginal birth after cesarean (VBAC) is that the scar on the uterus may break open (rupture) during labor. Women who have a low transverse cesarean scar have a lower risk of rupturing than women who have a vertical incision scar. About 5 out of 1,000 women (0.5%) with a low transverse scar have a uterine rupture during a trial of labor.footnote 1

A woman's risk of uterine rupture increases with:

  • Each additional uterine surgical scar.
  • Any uterine scar that reaches above the lower, thinner part of the uterus, such as a vertical (classical) scar.
  • The use of medicine to start (induce) labor. Some doctors avoid the use of any medicine to start a VBAC trial of labor. Other doctors are comfortable with the careful use of certain medicines to start labor.

In the rare event that a uterine scar ruptures, it can be dangerous to both the mother and her infant.

Depending on severity, a rupture can:

  • Be mild and harmless.
  • Often be repaired. If it is not repairable, the uterus is removed (hysterectomy).
  • Cause severe maternal bleeding and a decrease in oxygen to the baby.
  • Cause fetal brain damage or death.

References

Citations

  1. Guise JM, et al. (2010). Vaginal birth after cesarean: New insights. Evidence Report (Publication No. 10-E003). Rockville, MD: Agency for Healthcare Research and Quality.

Credits

Current as of: June 16, 2021

Author: Healthwise Staff
Medical Review:
Sarah Marshall MD - Family Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Kirtly Jones MD - Obstetrics and Gynecology

Symptom Checker

Feeling under the weather?

Use our interactive symptom checker to evaluate your symptoms and determine appropriate action or treatment.

Interactive Tools

Get started learning more about your health!

Our Interactive Tools can help you make smart decisions for a healthier life. You'll find personal calculators and tools for health and fitness, lifestyle checkups, and pregnancy.