What is the risk of uterine rupture in a Vaginal Birth After Caesarean (VBAC)?
There are two types of event which are sometimes lumped together as ‘uterine rupture’. The first, and most common, is a ‘dehiscence’. This is where the scar starts to undo, but only by a small amount; neither mother or baby are affected. These are often called ‘asymptomatic’ ruptures as no symptoms are shown by mother or baby – nobody is hurt. The dehiscence is noticed only where a repeat caesarean is performed for reasons apart from symptoms of uterine rupture, or when there is a manual exploration of the uterus after VBAC. This means that the doctor puts her hand into the uterus and feels for tears. Such explorations are not routinely done nowadays because of risk of discomfort and infection for the mother, so many dehiscences could pass unnoticed if the mother has a VBAC. True uterine rupture is symptomatic, which means that the mother is losing enough blood for her and the baby to be affected. Her blood pressure falls, her pulse changes, she may experience abnormal pain in one area
