title: 4th stage transvaginal omental herniation during VBAC complicated by shoulder dystocia: a unique presentation of uterine rupture.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Transmara District Hospital, P,O Box 98-40700, Kilgoris, Kenya. arumwesta@gmail.com
authors.forename: Aruyaru Stanley
authors.initials: AS
authors.lastname: Mwenda
mesh_terms: D004420:Dystocia / Q000175:diagnosis* / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D006547:Hernia / Q000175:diagnosis; D006801:Humans; D007743:Labor, Obstetric; D011247:Pregnancy; D050497:Stillbirth; D014597:Uterine Rupture / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects*; D014623:Vaginal Diseases / Q000175:diagnosis