The majority of women will not experience a uterine rupture, which is a tear in the uterine wall. It is extremely rare for women who have never had a prior cesarean section, but for those with prior surgical delivery, the odds increase to somewhere around 1%. A study on data from 1976 to 2012 shows that the overall rate is one in 1,146 or about .07%. A uterine rupture is a medical emergency, however, and failure to timely diagnose and intervene can cause injury to the mother and unborn baby.
If you or your child suffered the impacts of a uterine rupture, The Becker Law Firm can help. Call 216-621-3000 to speak with a uterine rupture attorney in Ohio about your legal options.
How Do Uterine Ruptures Occur?
In a patient with a prior cesarean section, a uterine rupture can occur when the internal forces from pregnancy and contractions cause pressure on the weakest part of the uterine wall—the location of a previous incision. Different types of incisions yield different risks—the lowest risks are low-transverse uterine incisions. Higher risk incisions include classical incisions, which extend into the upper part of the uterus. Women with those incisions should never undergo a course of labor (called a VBAC—vaginal birth after cesarean) because of the high risks.
Importantly, other types of abdominal surgery may also increase the risk of uterine rupture. Examples include fibroid removal surgery or any other procedure on the uterus. Sometimes trauma (like a car accident) can cause a uterine rupture.
Detecting and diagnosing a uterine rupture early is essential, and nurses, doctors, and midwives must be alert and intervene immediately when uterine rupture is suspected. Signs and symptoms in the baby can include abnormalities in the baby’s heart rate, which can often be detected through electronic fetal monitoring (EFM). In the mother, some indications of uterine rupture include stomach pain, quick pulse or signs of shock, pain in the chest, vaginal bleeding, or discontinuation of contractions.
Risk Factors for Uterine Rupture
Women in the following categories have additional risks associated with uterine rupture:
- Previous uterine surgery
- Obstructed labor
- Multiple prior births (the risk goes up with the number of prior births)
- Breech baby
- Trauma (like a car accident)
- Forceps delivery
- Pushing on the mother’s stomach during labor and delivery
- Improper medication
What Are the Risks to the Baby?
The most serious risks to the baby are brain damage or death. For this reason, an emergency cesarean section is necessary. Any time that a doctor, nurse, or midwife suspects a uterine rupture, steps must be taken immediately to expedite delivery. In the case of a suspected uterine rupture, time is of the essence and every minute counts to increase both the mom’s and baby’s chances for a positive outcome.
Injuries caused by a uterine rupture that has not been timely identified or treated include:
- Wrongful death/stillbirth of the baby, usually caused by hemorrhage or anoxic brain injury
- Developmental delays
- Cerebral palsy
What Are the Risks to the Mother?
For the mother, bleeding is the most severe risk. Without timely intervention, the mother could lose too much blood, causing hypovolemic shock and sometimes even death. Other risks include infection and a possibility that a hysterectomy is necessary to stop the bleeding. If a hysterectomy is warranted, it will prevent the mother from carrying future children.
How Should a Medical Team React to a Uterine Rupture?
It is critical to get the baby out of the uterus expeditiously when a uterine rupture occurs. Inside the uterus, the baby is at risk of blood loss and oxygen deprivation. This can lead to brain injury, death, or both. Additionally, because of blood loss, the mother may require a transfusion and will likely have antibiotics to prevent serious infection. If doctors cannot repair the uterus, a hysterectomy (removal of the uterus) will be necessary.
Doctors and nurses who fail to timely recognize the warning signs of a uterine rupture do so at great risk to their patients. Proper treatment may include a laparotomy (surgery into the abdomen) and repair of the uterus.
