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Rates of uterine rupture during vaginal birth following one previous C-section, done by the typical technique, are estimated at 0.9%. [1] Rates are greater among those who have had multiple prior C-sections or an atypical type of C-section. [1] In those who do have uterine scarring, the risk during a vaginal birth is about 1 per 12,000. [1]
It was found that between unlocked single-layer closure and double-layer closure, there is no difference in risk of uterine rupture, [3] however the risk of rupture is increased with a locked single-layer suture. [18] Following the repair of the incision, a scar defect may form, which is defined as a thinning of uterine muscle at the incision site.
When there is bleeding due to uterine rupture a repair can be performed but most of the time a hysterectomy is needed. [ citation needed ] There is currently no reliable evidence from randomised clinical trials about the effectiveness or risks of mechanical and surgical methods of treating postpartum bleeding.
Risks of fetal surgery, specifically prenatal spina bifida repair, include premature rupture of membranes, uterine rupture in future pregnancies, premature birth and intraspinal inclusion cysts or a tethered cord in the fetus or newborn baby. [4] Open fetal surgery has proven to be reasonably safe for the mother. [3]
Prelabor rupture of membranes (PROM), previously known as premature rupture of membranes, is breakage of the amniotic sac before the onset of labour. [2] Women usually experience a painless gush or a steady leakage of fluid from the vagina. [1] Complications in the baby may include premature birth, cord compression, and infection.
A caesarean section leaves a scar in the wall of the uterus which is considered weaker than the normal uterine wall. A VBAC carries a risk of uterine rupture of 22–74/10,000. Slightly lower risk of uterine rupture in women undergoing ERCS (i.e. a section before the onset of labour). [1]
In 2015 about 6.5 million cases of obstructed labour or uterine rupture occurred. [5] This resulted in 23,000 maternal deaths down from 29,000 deaths in 1990 (about 8% of all deaths related to pregnancy). [2] [6] [9] It is also one of the leading causes of stillbirth. [10] Most deaths due to this condition occur in the developing world. [1]
The repair of most genital injuries require suture and the bleeding from the area is usually minimal. [3] The bleeding that results from extreme vaginal tears can be copious, leading to hemorrhagic shock, and the patient may need a blood transfusion. Treatment of these lacerations could warrant surgical repair. [2]