Who's most at risk for uterine rupture?

Women who have not previously given birth vaginally and those whose labor is induced with a prostaglandin are at higher risk of uterine rupture and, in turn, infant death.

A population-based study of almost 36,000 women in Scotland found that women who did not previously deliver vaginally were 2.5 times more likely to experience uterine rupture than those who did. Similarly, those whose labor was induced with a prostaglandin were almost 3 times as likely to experience uterine rupture as women whose labor was not.

The study also found that the risk of perinatal death due to uterine rupture was almost 3 times higher in hospitals with less than 3,000 births per year than in hospitals with 3,000 or more births per year. The authors of the study believe the difference is largely due to the fact that hospitals with higher throughput are more likely to have resident obstetric, anaesthetic, and neonatal services, as well as dedicated obstetric operating rooms, all of which leads to faster response and more rapid delivery and resuscitation of neonates.