Who is at risk for uterine rupture?
Women who have had previous surgery on the uterus, particularly on the upper muscular portion (cesareans that were not low transverse) are at increased risk for uterine rupture. Prior classical cesareans, where the incision is near the top of the uterus, prior removal of fibroid tumors if the incision extended through the full thickness of the uterine wall, any other uterine surgery that went through the full depth of the muscular portion of the uterus, or multiple (three or more) prior low transverse cesareans all put a pregnant woman at increased risk. Even without prior surgery, having had more than five full-term pregnancies, having an overdistended uterus (as with twins or other multiples), abnormal positions of the baby such as transverse lie, and the use of Pitocin and other labor-inducing medications like prostaglandins may increase the risk. There is no evidence that D&C, first-trimester abortion, removal of superficial fibroids, or pelvic surgery that did not involve the uter
