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Uterine rupture: risk factors and pregnancy outcome.
- Source :
-
American journal of obstetrics and gynecology [Am J Obstet Gynecol] 2003 Oct; Vol. 189 (4), pp. 1042-6. - Publication Year :
- 2003
-
Abstract
- Objectives: This study aimed at determining risk factors and pregnancy outcome in women with uterine rupture.<br />Study Design: We conducted a population-based study, comparing all singleton deliveries with and without uterine rupture between 1988 and 1999.<br />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).<br />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.
- Subjects :
- Adult
Cesarean Section
Cesarean Section, Repeat
Dystocia complications
Female
Humans
Infant Mortality
Infant, Newborn
Labor Presentation
Labor Stage, Second
Multivariate Analysis
Obstetric Labor Complications etiology
Pregnancy
Risk Factors
Uterine Rupture etiology
Pregnancy Outcome
Uterine Rupture complications
Subjects
Details
- Language :
- English
- ISSN :
- 0002-9378
- Volume :
- 189
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- American journal of obstetrics and gynecology
- Publication Type :
- Academic Journal
- Accession number :
- 14586352
- Full Text :
- https://doi.org/10.1067/s0002-9378(03)01052-4