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The most rare yet most serious risk of
vaginal birth after cesarean (VBAC) is that the scar
on the uterus may break open (rupture) during labor. Women who have a low transverse cesarean
scar have a lower risk of rupturing than women who have a vertical incision scar.
About 5 to 9 out of 1,000 women (0.5% to 0.9%) with a low transverse scar
have a uterine rupture during a trial of labor.1
A woman's risk of uterine rupture increases with:
It is likely that the women who have a rupture have other
risk factors, which are things that make them more likely to have this complication.
Having had a vaginal delivery during another pregnancy lowers the risk of
uterine rupture during VBAC. Women who have delivered vaginally and later had a
cesarean delivery have about one-fourth the risk of women who have had a
cesarean delivery but no vaginal delivery.1
In the rare event that a uterine scar ruptures, it can be dangerous to
both the mother and her infant.
Depending on severity, a rupture can:
American College of Obstetricians and Gynecologists (2010). Vaginal birth after previous cesarean delivery. ACOG Practice Bulletin No. 115. Obstetrics and Gynecology, 116(2): 450–463.
March 29, 2013
Sarah Marshall, MD - Family Medicine & Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
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