A late presentation of uterine rupture following a vaginal birth after cesarean section (VBAC): A case report

Abstract

Over the past 30 years, rates of cesarean section (CS) delivery have increased significantly. According to the World Health Organization (WHO), cesarean section rates have risen from around 7% worldwide in 1990, to 21% in 2021. As a result, physicians are more likely to encounter patients who have opted to undergo vaginal birth after cesarean section (VBAC). Uterine rupture is a rare but potentially life-threatening complication of VBAC. It typically has an acute intrapartum presentation, with abdominal pain, vaginal bleeding, and abnormal cardiotocography; however, there have been a few reported cases occurring postpartum. Here, we present a case of a 31-year-old woman seen at the emergency department of the Queen Elizabeth Hospital, Barbados, who was found to have a uterine rupture following a VBAC. She had no acute intrapartum signs of rupture, but rather, presented with symptoms consistent with generalized peritonitis and bowel obstruction three days following delivery. She ultimately underwent a laparotomy with repair of the rupture and had an uncomplicated recovery.