Uterine rupture is a serious medical complication in which the uterine muscle separates, usually along a previous scar line. Rupture most frequently occurs during labor, when the muscles of the uterus, weakened at this scar line, are stretched and stressed, causing them to split. Ruptures constitute an emergency medical situation for both the woman and the fetus to prevent hemorrhaging or even death.

So who's at risk for uterine rupture, and how is it prevented?

Most commonly, ruptures occur in women who have had prior surgery to open the uterus, most often a previous Cesarean section. However, even among these women, all risk is not equal.

"The risk of uterine rupture varies depending on the type of incision used during the C-section," says Dr. Frances A. Smith, chief of OB/GYN at Kelsey-Seybold Clinic in Houston, Texas. "The rupture risk can be as high as 9 percent for women who have a vertical scar from a previous C-section. Low, horizontal incisions are more common today and carry about a 1 percent risk for subsequent uterine rupture."

The more C-sections a woman has had, the greater the possibility of the uterus being weakened at the point of the scar. "Because of these risks, obstetricians will usually not allow women who have had more than one C-section to go into labor and deliver vaginally," Dr. Smith says.

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