how fast/slow is a uterine rupture?

[alice77]

I'm planning on staying at home for as long as possible for my hoped-for-VBAC in Jan 09. I've read that if you start to rupture you need to be able to get into theatre within half an hour. But a doula was telling me yesterday that it takes a while so I have plenty of time to make my way from home to hospital if it were to start to happen.

Does anyone have accurate info as to what to expect in terms of time (and sensation) if you were to start to rupture?

[Salsa]

I know little about it myself, but will read what posts you get. I`m hoping to stay home as long as possible too, and although I know the chance of rupture is small, its something I have been wondering about, especially as my c.section scar is twice the length of a usual one.
As far as I`m aware you have about 15 -20mins for a c.section to be preformed from when rupture begins to occur, to minamise loss of baby and or mother lives or other serious complications.
Its not long, but have been told that its enough time to get to the hospital from my house if I need... but I`m wondering how do you know if thats whats happening? I get all sorts of sharp pains anyway, and Im the sort to think 'oh, it`ll be ok'.

[Alan]

Hi Alice77
A uterine rupture can occur at any time during your labour and can happen within a relatively short time. However the chance of your uterus rupturing is less than 0.7%. Most of these ruptures do not cause any problems, in fact, for some women, the only reason that they know that their uterus has ruptured is because the woman has had to have another CS and the uterine was discovered then.
A few signs that your uterus has ruptured are:-
A sharp pain on your previous scar that does not go away when the contractions stop.
A bulging in your lower tummy just above your pubic bone. (this is caused by the baby’s head)
Vaginal bleeding
Low heart rate of baby
Baby’s head moves back up the birth canal

[gardeningkate]

Does that mean that out of the 0.7% of ruptures, not all of them are serious, is there anyway to get an idea of what % of actual ruptures are serious, and if I have had some tearing at the edges of my old scar (again which might not have been noticed had I not had that second CS) does that make a difference? Not that it matters, I have made up my mind anyway to go for VBAC2, but it would be nice to know.

[Alan]

Hi Gardeningkate
Yes most of the uterine ruptures are not serious. In fact you have a higher chance of having a hysterectomy if you go for a second CS than your uterus rupturing from a VBAC.

[lovemybubs]

So you have like 20 mins to get the baby out if you start to rupture? I was told that if I go after hours that a team would have to be called in from home to do the C Section, so how is it at all safe not to have called the team in once it is confirmed im in labour JIC?

I hear what Alan is saying, that most ruptures as fine but in my case does it mean if it goes seriously wrong then im pretty much stuffed as i have to wait for ppl to be called and then show up? (if its 'out of hours')

[Alan]

Calling it a ruptured uterus is not really a good term. This gives the impression that the uterus will just burst instantly. Even though this can happen it is very unusual. What normally happens is that the old scar starts to tear open. This tearing can stop after a few millimetres or it can continue until the whole scar has opened up. How quickly you need to get the baby out would depend on how long it takes the scar to open enough to be dangerous. Symptoms of a uterine rupture could and often do occur well before there is a danger to you or your baby.