Published: 2020-10-27

Previous caesarean scar rupture: mortality averted a case report

Ajay Kumar, Anuj Singh, V. B. Tripathi


Uterine rupture at the site of a previous cesarean section scar is an uncommon but catastrophic complication of pregnancy by associated with significant foetal and maternal mortality and morbidity. A 31-year old woman, G6P3A2L1 with previous lower segment cesarian section (LSCS), booked case was admitted at 37 week of gestation with complaint of leaking per vaginal (P/V) in our tertiary care centre. Patient had spontaneous labor pain, which subsided after few contractions and sustained hemorrhagic shock with utero placental insufficiency due to previous LSCS scar rupture. Due diligence and expeditious caesarean management strategy needs to be adopted in parturient with previous caesarean patients owing due to risk of scar rupture. Ultrasonography is a useful tool which can be used to assess women with previous cesarean section to carry out risk stratification for subsequent pregnancies.


Caesarean section, Scar, Labor, Haemorrhage, Uteroplacental

Full Text:



District level household and facility survey (DLHS-3). Mumbai: International Institute for Population Sciences. Available at: Accessed on: 25 July 2020.

Jastrow N, Chaillet N, Roberge S, Morency AM, Lacasse Y, Bujold E. Sonographic lower uterine segment thickness and risk of uterine scar defect: asystematic review. J Obstet Gynaecol Can. 2010;32(4):321-7.

Ofili-Yebovi D, Ben-Nagi J, Sawyer E, Yazbek J, Lee C, Gonzalez J, et al. Deficient lower-segment Cesarean section scars: prevalence and risk factors. Ultrasound Obstet Gynecol. 2008;31(1):72-7.

Kok N, Wiersma IC, Opmeer BC, de Graaf IM, Mol BW, Pajkrt E. Sonographic measurement of lower uterine segment thickness to predict uterine rupture during a trial of labor in women with previous cesarean section: a meta-analysis. Ultrasound Obstet Gynecol. 2013;42:132-9.

Landon MB, Spong CY, Thom E, Hauth JC, Bloom SL, Varner MW, et al. Risk of uterine rupture with a trial of labor in women with multiple and single prior cesarean delivery. Obstet Gynecol. 2006;108(1):12-20.

Zwart JJ, Richters JM, Ory F, de Vries JI, Bloemenkamp KW, van Roosmalen J. Uterine rupture in The Netherlands: a nation wide population based cohort study. BJOG. 2009;116(8):1069-78.

Hofmeyr GJ, Say L, Gulmezoglu AM. WHO systematic review of maternal mortality and morbidity :the prevalence of uterine rupture. BJOG. 2005;112(9):1221-8.

Guise JM, Denman MA, Emeis C, Marshall N, Walker M, Fu R, et al. Vaginal birth after cesarean: new insights. Evid Rep Technol Assess (FullRep). 2010;191:1-397.

Sharma C, Surya M, Soni A, Soni PK, Verma A, Verma S. Sonographic prediction of scar dehiscence in women with previous cesarean section. J Obstet Gynaecol India. 2015;65(2):97-103.

Krausz MM. Initial resuscitation of hemorrhagic shock. World J Emerg Surg. 2006;1:14.