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Risk factors for uterine rupture during VBAC
By Mayo Clinic staffAlthough uterine rupture is rare, it's a valid concern. In fact, fear of uterine rupture is the reason VBAC wasn't done for decades. To put the risk in perspective, consider the odds of uterine rupture for women who have various types of uterine scars.
| If you have this type of uterine incision: | The risk of uterine rupture is: |
|---|---|
| A low transverse uterine incision | 0.2 percent to 1.5 percent — or less than two out of 100 women |
| A low vertical uterine incision | 1 percent to 7 percent, depending on how far the incision extends into the upper uterus — or one to seven out of 100 women |
| An up-and-down (classical) uterine incision | 4 percent to 9 percent — or four to nine out of 100 women |
In addition to the type of uterine incision, other factors may increase the risk of uterine rupture during VBAC, including:
- Single-layer suturing. If your prior C-section incision was closed with one layer of stitches instead of two, the scar may not be as strong. Most C-section incisions are closed with two layers.
- Short time since prior C-section. Women who attempt VBAC less than 18 to 24 months after having a C-section have a two to three times greater risk of uterine rupture. The longer the interval between deliveries, the lower the risk of rupture.
- Labor-inducing drugs. Inducing labor with medication may increase the risk of uterine rupture. If your doctor decides that it's best for your baby to be delivered before labor begins naturally, he or she will probably recommend a repeat C-section.
