In a previous post on this blog, one post about the possible benefits of a c section delivery had raised a number of very agitated comments and among those a very grave and germane issue was raised, which we seek to address through this post; that of increased chances of uterine rupture in subsequent pregnancies due to a prior c section delivery.
It may not be out of place to mention that we value the input of all our readers and particularly their insightful, knowledgeable and sometimes impassioned comments and contributions.
A uterine rupture is one of the most fearful complications that can arise from a pregnancy and which can end in the death of both child and mother.
Though this is not a common occurrence it is a serious one and can have consequences such as hysterectomy, urologic injury, or need for a blood transfusion for the mother, and neurologic impairment in the infant. Uterine rupture is when the myometrial wall is breached either partially or completely.
A Uterine rupture can occur during labor but also it can occur during the later part of pregnancy.
Although a uterine rupture is not a common occurrence, the risk of a uterine rupture is considerably increased by virtue of a prior cesarean section birth; what is known as a VBAC or Vaginal birth after c section.
A study conducted found that the rate of Uterine rupture for women who underwent a c section for the second time, (without labor) was about 1.6 per one thousand women.
However this statistic went up considerably when hormone prostaglandin was used to induce labor in the women to assist them to deliver vaginally.
Also women who have undergone a c section and who have a subsequent pregnancy wherein they go into labor also have a higher risk of uterine rupture even if there is not the attempt made to deliver vaginally. Simply going into labor can cause a rupture when there has been a previous c section.
Women who have had any previous surgery (even other than c sections, such as removal of fibroids etc) in the upper muscular portion of the uterus are also at higher risk from uterine rupture. This risk increases with surgery in the upper portion as against low transverse surgery. Repeated low transverse c sections (three or more it some experts believe) also increase this risk.
The risk of uterine rupture also increases with more than 5 full term pregnancies or from having the uterus reach a state of over-distension which can also result from multiple pregnancies or the baby being in an unusual position in the uterus.