子宫破裂是一种严重威胁母儿生命安全的围产期并发症。随着生育政策的开放，国内孕产妇子宫破裂的发生率有上升趋势，主要原因是瘢痕子宫。瘢痕子宫的成因除剖宫产外，还有非产科因素的子宫手术史，后者也是最容易被忽视的病因。瘢痕子宫的子宫破裂多在阴道分娩过程中发生，但胎盘植入可导致妊娠中晚期的自发子宫破裂，值得临床关注。腹痛、阴道流血和胎心下降是子宫破裂常见的临床表现，妊娠中晚期隐匿性的子宫破裂则常以腹痛和休克症状为临床表现。因此，子宫破裂的早期识别和及时手术治疗与母儿结局息息相关。文章着重阐述了子宫破裂的常见原因及临床表现，以期提高临床医生的警惕性，改善此类孕产妇的母儿结局。

Uterine rupture is a perinatal complication that seriously threatens the life of the mother and fetus. With the opening of the fertility policy，the incidence of uterine rupture in pregnant women in China is on the rise. The main cause of uterine rupture is scarred uterus. The cause of scarred uterus includes not only cesarean section but also the history of uterine surgery with non-obstetrical factors，which is also the most easily neglected cause. Uterine rupture of scarred uterus often occurs in the process of vaginal delivery，but placental implantation can lead to spontaneous uterine rupture in the middle and third trimester of pregnancy，which is worthy of clinical attention. Abdominal pain，vaginal bleeding，and decreased fetal heart rate are common clinical manifestations of uterine rupture，while occult uterine rupture in the middle and third trimester of pregnancy is often characterized by abdominal pain and shock. Therefore，the early identification and timely surgical treatments of uterine rupture are closely related to the maternal and fetal outcomes. We focus on the common causes and clinical manifestations of uterine rupture，hoping to improve the vigilance of clinicians and improve the maternal and fetal outcomes.