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Estimates of Risks of Uterine Rupture

This is a chart from Dr. Marsden Wagner’s wonderful book, "Born in the USA."  He includes quite a bit of information about VBAC and homebirth.  I highly recommend every pregnant woman read it.

Normal (unscarred) uterus: 1 in 33,000 births
VBAC–no induction: 1 in 200 births
VBAC–oxytocin (Pitocin) augmentation: 1 in 100 births
VBAC–oxytocin induction: 1 in 43 births
VBAC–Cytotec induction: 1 in 20 births
Normal (unscarred) uterus with Cytotec induction: UNKNOWN*
Neurological injury or death of baby after uterine rupture: 30 percent
Death of woman after uterine rupture: 1-2 percent

*Best scientific opinion–all evidence currently available shows
significantly increased risk of rupture of unscarred uterus with
Cytotec induction but the exact level of risk is known due to
inadequate sample size of studies.

SOURCES: Estimates are all conservative and based on data from the
CDC, ACOG, and two papers:
M. Plaut, M. Schwartz, and S. Lubarsky, "Uterine Rupture Associated with
the Use of Misoprostol in the Gravid Patient with a Previous Cesarean
Section," American Journal of Obstetrics and Gynecology 180, no. 6 (1999):
H. Blanchette, S. Nayak, and S. Erasmus, "Comparison of the Safety and
Efficacy of Intravaginal Misoprostol with Those of Dinoprostone for
Cervical Ripening and Induction of Labor in a Community Hospital,"
American Journal of Obstetrics and Gynecology 180, no. 6 (1999): 1543-50.

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