Uterine rupture
Symptoms
There are two types of ruptures, the first is called a Dehiscence rupture and describes a partial rupture where the scar starts to undo. Neither the mother nor the baby will be affected by this.
The second type of rupture is called a symtomatic rupture and describes a scar that has completely ruptured. Symptoms are likely to be severe bleeding, severe pain and foetal distress, but often the rupture will be silent and painless. Ruptures tend to happen during labour but can happen beforehand. During labour your blood pressure my drop and you may experience pain in one area even if you have had an epidural. Any time you experience bleeding or abdominal pain it is advisable to seek medical help immediately. With this type of rupture your baby is likely to be delivered by caesarean section immediately.
Warning signs of uterine rupture
The first warning signs of uterine rupture are unusual changes in your baby's heartbeat. VBAC births in hospitals are generally monitored so that these abnormal heartbeat changes can be identified as soon as they start to happen. If your baby does seem to have unusual changes in his heartbeat you should be offered a Caesarean section immediately. Other warning signs are as above; severe bleeding, severe abdominal pain and signs that your baby is in distress. Other signs to watch out for are recession of the fetal head and bulging of the abdomen immediately after a drop in the baby's heart rate.
Induction of labour
Research has shown that women who are induced with prosaglandin gel such as Prostin, or oxytocin such as Pitocin or Syntocinon are at a higher risk of uterine rupture. In fact many hospitals in the UK will not induce women who have had previous C-sectons and instead opt for a repeat Caesarean.
Assisted delivery
Assisted deliveries such as using forceps or a ventouse to delivery the baby have been known to increase the risk of suffering from uterine rupture.
Your midwife or GP can check your existing scar on antenatal visits if you are worried. the fear of experiencing a uterine rupture should not put you off attempting to have a VBAC, however if you know the facts and warning signs to look out for you will feel more prepared as labour progressess. Midwifes are now very knowledgeable about uterine rupture so should be able to spot the warning signs if they are happening.
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Mothercare
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