While uterine ruptures are rare, they can be dangerous for women in labour. We take a look at what it means…
What is it?
A very rare complication – uterine rupture affects just fewer than one out of 100 women who've had a previous uterine incision — commonly for a c-section. It's a tear in the wall of the uterus that usually happens during labour. ‘It often happens if a woman has had a c-section, which causes skin around old scars to become weaker and more likely to give way under the stress of contractions, says Lesley Regan, Professor of Obstetrics and Gynaecology. This is why when you’re attempting a vaginal birth after a caesarean, you’ll need close monitoring. Rarer causes include having had lots of children, a placenta that sits too deeply into the uterine wall or a distended uterus, which can happen from carrying twins. Fortunately, ruptures tend to be quite rare and if you’ve never a c-section, or any type of uterine surgery, you’re unlikely to experience it.
What are the symptoms?
Most ruptures happen when you’re giving birth due to stress on your uterus, but occasionally they can happen just before, too. If they do happen, you should be in hospital and working with professional staff. ‘The rupture may be silent and painless,’ says Lesley. ‘Or you might experience abdominal pain, a vaginal bleeding, a rapid pulse and other signs of shock.’ Some women also get chest pain too, as internal bleeding irritates the diaphragm. Your labour may slow down or stop completely and your baby’s heart rate will become abnormal. But if you have a complete rupture, it’ll tear all the layers of the uterine wall and the consequences can be really dangerous for you and your baby. While smaller tears will only tear through some of the tissue.
What can you do?
Once it’s clear you’ve had a rupture, you’ll be given an emergency c-section to deliver your baby. Usually, if the damage is limited, your uterus will be repaired and there won’t be a need for a hysterectomy. You’ll be given antibiotics to prevent infection and once you can go home you’ll need lots of recovery time from surgery and losing so much blood. You won’t be able to do strenuous exercise and drinking lots of fluids and eating healthily is really important. Iron supplements are recommended, too.
See your GP…
As ruptures happen mid-labour, you should have medical help at hand who can act quickly. But if you’re in early stages of contractions, seek medical attention if you experience a sudden onset of strong abdominal pain, bleeding, a rapid pulse or other abnormal symptoms.