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

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.