What exactly causes uterine rupture? Contractions? Pushing? — The Bump

What exactly causes uterine rupture? Contractions? Pushing?

I'm waiting for all my books to arrive and what I'm finding on the internet isn't very informative.  I know it can happen before or during labor and sometimes I worry that I'll be holding back during delivery because of fear of pushing too hard will make it rip open.  I'm a very visual person i keep thinking of my uterus as a water balloon with a week spot and if I start squeezing it (contractions) that weak spot will split. I know this isn't really the case...So is there something specifically that causes rupture? 

Re: What exactly causes uterine rupture? Contractions? Pushing?

  • my understanding is that a rupture in a scarred uterus occurs because the scar can sometimes be weaker than the muscle was prior to the surgery.  I sort of picture it as like a pilliow or something with a reinforced seam.

    Most of what I have read says that rupture is more likey to occur prior to labor.  That sort of gave me peace when I reallized I was in labor with DD because I felt like my risk was lower (even though I don't know statistically if they were).  Also, it sort of gave me (and gives me now) some peace to know that any woman's uterus can rupture whether she has had uterine surgery or not.

    Also remember, that within the .07% rupture rate is a large variety of ruptures from catastrophic to so minor they are not known about unless the doctor internally checks the woman's uterus after birth.

    So all that to say, I don't think that there is one specific thing that causes rupture (aside from medical interventions).

    I think I also remember reading that the scar itself it actually stronger than the uterus was before the c/s, but I am not sure about that.  I also wonder if that is the case why the risk of rupture would be higher.

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  • Agree with pp.  Most of what I've read refers to "hyperstimulation" of the uterus or "weakening" of the prior incision (this is usually the result of medical induction for a VBAC, not augmentation of spontaneous VBAC labor).  Although there are also ruptures mentioned due to prolonged pushing (in excess of 4 hours I think).  HTH!

    ~Sweet Girl *8/18/08* c-section ~ Sweet Boy *12/2/10* VBAC ~ Sweet Boy *8/14/12* VBAC~ 


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  • Mine ruptured during labor.  I never got to the pushing stage.
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