Uterine rupture


Uterine rupture, with extruded amniotic sac seen with abdomen opened.
  • Spontaneous tearing of the uterus
  • May result in fetus being expelled into peritoneal cavity may result in the fetus being expelled into the peritoneal cavity.
  • Occurs in late pregnancy or active labor
  • Rare, prevalence:
    • No prior c-section = 0.01%
    • Prior c-section = 0.2-0.8%
  • Risk factors:
    • Prior c-section (major)- rupture most commonly occurs along prior scar lines
    • Malpresentation
    • Labor dystocia
    • Hypertension
    • Bicornuate uterus
    • Grand multiparity
    • Connective tissue disorder
    • Placenta percreta
    • Prior myomectomy
    • Misoprostol use (oxytocin likely safe)

Clinical Features

Differential Diagnosis

Vaginal Bleeding in Pregnancy (>20wks)

3rd Trimester/Postpartum Emergencies


Before emergency cesarean section, the fetus was stillborn. Uterine rupture with protrusion of amniotic cavity and placenta, massive hemoperitoneum, and the uterine wall defect (white arrow) are found on abdominal computerized tomography
  • Pelvic ultrasound
    • Disruption of myometrium
    • Free peritoneal fluid (FAST+)
    • Anhydramnios/empty uterus
    • Herniated amniotic sac
    • Fetal anatomy outside of uterus
    • Absence of FHR



  • Admission (emergently to operating room)

See Also

External Links