Uterine Rupture: Will It Affect Future Pregnancies?

During my first pregnancy, I experienced a severe uterine rupture during a cesarean. They gave me four units of blood during a two hour surgery. I want to have more children. Do you think I can have a successful pregnancy?


A uterine rupture can be a very serious event. It is not likely to occur during a cesarean, but usually before a cesarean. Perhaps they were calling a large laceration of the uterus (a tear from trying to get the baby out) during the cesarean, a "rupture." In either case, though, future pregnancies can be complicated by an increased risk of rupture -- usually during labor usually, but sometimes before labor. This risk is similar to anyone having had a previous cesarean has during subsequent pregnancies, only more risky because the size of the rupture may make it a little more likely that it may break open.

The way you phrase it, though, makes me think that it tore down into the cervix. If you had a big tear up the uterus, you would generally be cautioned against labor and a repeat cesarean would be recommended for future pregnancies.

If there was a tear into your cervix, it could cause an incompetent cervix. There are tests (though no good ones) to suggest that the cervix might be too weak to hold a pregnancy. In this case, a cerclage (a stitch around the cervix) would be helpful in maintaining the pregnancy. A cerclage for an incompetent cervix is about 95 percent successful at keeping a pregnancy until close to term (that might otherwise be lost at about 20 weeks).

It would be worth talking to your doctor to find out exactly what happened. That way you can see what tests they want to do and see what your risks of rupture or incompetent cervix might be. In most cases, you can safely have further pregnancies regardless of what happened. You will just have to be watched closely for problems as you go along.

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