Uterine rupture: risk factors and pregnancy outcome - 28/08/11
, Amalia Levy, PhD b, Miriam Katz, MD a, Moshe Mazor, MD a
Reprint requests: Eyal Sheiner, MD, Department of Obstetrics and Gynecology, Soroka University Medical Center, PO Box 151, Beer-Sheva 84101, Israel.Abstract |
Objectives |
This study aimed at determining risk factors and pregnancy outcome in women with uterine rupture.
Study design |
We conducted a population-based study, comparing all singleton deliveries with and without uterine rupture between 1988 and 1999.
Results |
Uterus rupture occurred in 0.035% (n=42) of all deliveries included in the study (n=117,685). Independent risk factors for uterine rupture in a multivariable analysis were as follows: previous cesarean section (odds ratio [OR]=6.0, 95% CI 3.2-11.4), malpresentation (OR=5.4, 95% CI 2.7-10.5), and dystocia during the second stage of labor (OR=13.7, 95% CI 6.4-29.3). Women with uterine rupture had more episodes of postpartum hemorrhage (50.0% vs 0.4%, P<.01), received more packed cell transfusions (54.8% vs 1.5%, P<.01), and required more hysterectomies (26.2% vs 0.04%, P<.01). Newborn infants delivered after uterine rupture were more frequently graded Apgar scores lower than 5 at 5 minutes and had higher rates of perinatal mortality when compared with those without rupture (10.3% vs 0.3%, P<.01; 19.0% vs 1.4%, P<.01, respectively).
Conclusion |
Uterine rupture, associated with previous cesarean section, malpresentation, and second-stage dystocia, is a major risk factor for maternal morbidity and neonatal mortality. Thus, a repeated cesarean delivery should be considered among parturients with a previous uterine scar, whose labor failed to progress.
Le texte complet de cet article est disponible en PDF.Keywords : Uterine rupture, cesarean section, perinatal mortality, maternal morbidity
Plan
 | Presented at the Twenty-Third Annual Meeting of the Society for Maternal-Fetal Medicine, San Francisco, Calif, February 3-8, 2003. This work is in satisfaction of K. Ofir, MD, requirements. |
Vol 189 - N° 4
P. 1042-1046 - octobre 2003 Retour au numéro
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