{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T16:05:17Z","timestamp":1782489917157,"version":"3.54.5"},"reference-count":46,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T00:00:00Z","timestamp":1684368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background and Objectives: Women with a history of cesarean section are a high-risk group because they are likely to develop uterine rupture during their next pregnancy. Current evidence suggests that a vaginal birth after cesarean section (VBAC) is associated with lower maternal mortality and morbidity than elective repeat cesarean delivery (ERCD). Additionally, research suggests that uterine rupture can occur in 0.47% of cases of trial of labor after cesarean section (TOLAC). Case Description: A healthy 32-year-old woman at 41 weeks of gestation, in her fourth pregnancy, was admitted to the hospital due to a dubious CTG record. Following this, the patient gave birth vaginally, underwent a cesarean section, and successfully underwent a VBAC. Due to her advanced gestational age and favorable cervix, the patient qualified for a trial of vaginal labor (TOL). During labor induction, she displayed a pathological CTG pattern and presented symptoms such as abdominal pain and heavy vaginal bleeding. Suspecting a violent uterine rupture, an emergency cesarean section was performed. The presumed diagnosis was confirmed during the procedure\u2014a full-thickness rupture of the pregnant uterus was found. The fetus was delivered without signs of life and successfully resuscitated after 3 min. The newborn girl of weight 3150 g had an Apgar score of 0\/6\/8\/8 at 1, 3, 5, and 10 min. The uterine wall rupture was closed with two layers of sutures. The patient was discharged 4 days after the cesarean section without significant complications, with a healthy newborn girl. Conclusions: Uterine rupture is a rare but severe obstetric emergency and can be associated with maternal and neonatal fatal outcomes. The risk of uterine rupture during a TOLAC attempt should always be considered, even if it is a subsequent TOLAC.<\/jats:p>","DOI":"10.3390\/jcm12103532","type":"journal-article","created":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T07:03:58Z","timestamp":1684393438000},"page":"3532","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Unexpected Uterine Rupture\u2014A Case Report, Review of the Literature and Clinical Suggestions"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5847-3092","authenticated-orcid":false,"given":"Wojciech","family":"Flis","sequence":"first","affiliation":[{"name":"Department of Perinatology, Gynecology and Gynecologic Oncology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, \u0141ukasiewicza 1, 85-821 Bydgoszcz, Poland"},{"name":"Department of Obstetrics and Gynecology, St. Adalbert\u2019s Hospital in Gda\u0144sk, Copernicus Healthcare Entity, Jana Paw\u0142a II 50, 80-462 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3327-3334","authenticated-orcid":false,"given":"Maciej W.","family":"Socha","sequence":"additional","affiliation":[{"name":"Department of Perinatology, Gynecology and Gynecologic Oncology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, \u0141ukasiewicza 1, 85-821 Bydgoszcz, Poland"},{"name":"Department of Obstetrics and Gynecology, St. Adalbert\u2019s Hospital in Gda\u0144sk, Copernicus Healthcare Entity, Jana Paw\u0142a II 50, 80-462 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3195-4515","authenticated-orcid":false,"given":"Mateusz","family":"Wart\u0119ga","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, M. Curie-Sk\u0142odowskiej 9, 85-094 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafa\u0142","family":"Cudnik","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, St. Adalbert\u2019s Hospital in Gda\u0144sk, Copernicus Healthcare Entity, Jana Paw\u0142a II 50, 80-462 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1136\/bmj.38160.634352.55","article-title":"Factors predisposing to perinatal death related to uterine rupture during attempted vaginal birth after caesarean section: Retrospective cohort study","volume":"329","author":"Smith","year":"2004","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1111\/j.1471-0528.2005.00725.x","article-title":"WHO systematic review of maternal mortality and morbidity: The prevalence of uterine rupture","volume":"112","author":"Hofmeyr","year":"2005","journal-title":"BJOG Int. 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