Uterine rupture during pregnancy: The URIDA (uterine rupture international data acquisition) study

Objective To describe the characteristics and peripartum outcomes of patients diagnosed with uterine rupture (UR) by an observational cohort retrospective study on 270 patients. Methods Demographic information, surgical history, symptoms, and postoperative outcome of maternal and neonates after UR were collected in a large database. The statistical analysis searched for correlation between UR, previous uterine interventions, fibroids, and the successive perinatal outcomes in patients with previous UR. Results UR was significantly associated with previous uterine surgery, occurring, on average, at 36,81 weeks of gestation in patients also without previous uterine surgery. UR did not rise exponentially with an increasing number of uterine operations. Fibroids were related to URs. The earliest UR occurred at 159 days after hysteroscopic myomectomy, followed by laparoscopic myomectomy (251 days) and laparotomic myomectomy (253 days). Fertility preservation was feasible in several patients. Gestational age and birth weight seemed not to be affected in the subsequent pregnancy. Conclusion data analysis showed that previous laparoscopic and abdominal myomectomy were associated with UR in pregnancy, and hysteroscopic myomectomy was associated at earlier gestational ages. UR did not increase exponentially with an increasing number of previous scars. UR should not be considered a contra-indication to future pregnancies.