Abstract
The risk of uterine rupture during attempted trial of labor after caesarean delivery (TOLAC) is well documented. However, vaginal rupture (in the absence of obstructed labour) is exceptionally uncommon. Below is described the rare case of a 37-year-old multiparous woman attempting TOLAC, who suffered a vaginal—rather than uterine—rupture, during the first stage of spontaneous labour. This case is an important reminder to obstetricians that concealed ruptures of both the vagina and uterus do occur and must be considered in clinical situations where another explanation is not apparent.
Highlights
The risk of uterine rupture during a trial of labor after caesarean delivery (TOLAC) is well documented [1]
A healthy 37-year-old multiparous woman, gravida two para one, presented to the birthing unit in spontaneous labour at term. She had an emergency lowersegment caesarean section (LSCS) for failure to progress in labour, at 8 cm cervical dilatation
Two minutes after the amniotomy, a ten-minute foetal bradycardia occurred, and the patient was transferred to theatres for an emergency LSCS
Summary
The risk of uterine rupture during a trial of labor after caesarean delivery (TOLAC) is well documented [1]. Is described the rare case of a patient attempting TOLAC who suffered a vaginal—rather than uterine—rupture, during the first stage of spontaneous labour
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