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Open Access Case report

4th Stage Transvaginal omental herniation during VBAC complicated by shoulder dystocia: a unique presentation of uterine rupture

Aruyaru Stanley Mwenda

Author Affiliations

Transmara District Hospital, P.O Box 98–40700, Kilgoris, Kenya

BMC Pregnancy and Childbirth 2013, 13:76  doi:10.1186/1471-2393-13-76

Published: 23 March 2013

Abstract

Background

Uterine rupture is a common complication in women attempting their first virginal birth after caesarean section (VBAC) but the risk diminishes with subsequent VBACs. It occurs in rates of 0.5-9% and is influenced by various factors.

Case presentation

A unique case of uterine rupture in a Kenyan woman of African descent during a repeat VBAC complicated by shoulder dystocia was discovered during the 4th stage of labour when omentum was noted protruding through the vagina. She had delivered 4 years earlier by caesarean section.

Conclusion

It is not common to experience uterine rupture among women attempting repeat VBAC. When it occurs, it may not always follow the known pattern intra-partum and is often associated with poor foetal outcome.