Objective — to make in-depth retrospective analysis of the follow-ups of pregnant women with the inoperable uterus and uterine ruptures occurring during labor in order to reveal their causes; to propose recommendations for reducing their rates; and to confirm the expediency of organ-sparing surgery for uterine ruptures during labor. Subject and methods. The histories and epicrises of childbirth were examined in 92 patients who had delivered a baby at the obstetric hospitals of the Moscow Healthcare Department in 2004 to 2013 and at the Perinatal Medical Center in 2006 to 2013, who had been clinically diagnosed as having uterine rupture. An analysis was made in relation to the pathogenesis of the ruptures (mechanical, histopathic, or forced) and to the mode of delivery (spontaneous delivery or cesarean section). Results. The underestimation of symptoms of impending rupture and the continuation of wait-and-see labor management, lack of alertness for possible uterine rupture during childbirth in patients with repeated curettage of the uterine walls and in multiparas, and, in some cases, the insufficient professional training of a physician conducting childbirth should be considered as the causes of an accomplished uterine rupture. Mechanical ruptures can be prevented by thoroughly monitoring the lower uterine segment and fetal head promotion and by timely performing a cesarean section. The prevention of histopathic uterine ruptures in multiparas and patients having a history of surgical intrauterine interventions is difficult and requires much attention and alertness during labor and exclusion of medications and mechanical procedures to accelerate fetal expulsion. Forced uterine ruptures should be ruled out by improving the quality of physicians’ professional training. To suture inoperable uterus rupture at childbirth is the treatment of choice. Conclusion. Rupture of the inoperable uterus remains a rare obstetric complication difficult to be diagnosed. Organ-sparing surgery is its treatment of choice. Each labor and deliver obstetrician/gynecologist, a novice one in particular, must continuously improve his/her professional levels in order to reduce the number of ruptures of the inoperable uterus during labor. The authors declare no conflicts of interest.