Uterine Rupture During VBAC Trial of Labor: Risk Factors and Fetal Response

For the woman with a prior uterine scar, neither repeat elective cesarean birth nor vaginal birth after cesarean birth (VBAC) trial of labor (TOL) is risk‐free. When VBAC‐TOL is successful, it is associated with less morbidity than repeat cesarean birth. However, when VBAC‐TOL fails due to uterine rupture, severe consequences often ensue. The challenge for clinicians today is to provide women who desire TOL after cesarean birth, a more individualized risk assessment of uterine rupture, thereby enhancing success and optimizing outcome. This article examines major risk factors for uterine rupture during VBAC‐TOL. In addition, fetal response to uterine rupture and neonatal outcomes are reviewed.