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Objective: To investigate the clinical characteristics and pregnancy outcomes of women with uterine rupture. Methods: This retrospective study analyzed clinical data from 43 women who experienced uterine rupture during delivery at the Affiliated Obstetrics and Gynaecology Hospital of Nanjing Medical University from December 2016 to December 2022. The participants were divided into scarred and non-scarred uterus groups based on their histories of uterine surgery. Additionally, the delivery outcomes of 20 women who underwent vaginal trial of labor was analyzed. Results: Of the 43 cases, 33 women involved a scarred uterus group, and 10 women involved a non-scarred uterus group. The non-scarred uterus group exhibited significantly higher intraoperative blood loss ≥ 1 000 mL（P ＜ 0.001）and cumulative blood loss ≥1 000 mL（P=0.003）compared to the scarred uterus group, along with a higher rate of blood transfusion（P=0.012). Among those 43 cases, 23 women underwent expected cesarean sections, while 20 opted for vaginal trial delivery. In the vaginal trial delivery patients, there was a notable increase in complete uterine ruptures（P=0.044）and rate of blood transfusion（P ＜ 0.001）in the group with uterine rupture detected during delivery（7 cases), compared with the group with uterine rupture detected after delivery（13 cases). Furthermore, the group with uterine rupture detected during delivery showed a higher incidence of abnormal amniotic fluid and fetal heart rate changes. Although these differences did not reach statistical significance（P ＞ 0.05), they still warrant significant clinical attention. Conclusion: Non-scarred uterus exhibit more bleeding when rupture occurs. Patients undergoing vaginal trial delivery who experience postpartum uterine rupture face more severe complications. It is essential to closely monitor amniotic fluid, fetal heart rate, and vital signs before and after delivery to promptly detect uterine rupture and reduce adverse pregnancy outcomes. [ABSTRACT FROM AUTHOR]