Association between Births by Caesarean Section and Uterine Rupture (original) (raw)
Related papers
Scientific reports, 2017
Caesarean section (CS) is increasing globally, and women with prior CS are at higher risk of uterine rupture in subsequent pregnancies. However, little is known about the incidence, risk factors, and outcomes of uterine rupture in women with prior CS, especially in developing countries. To investigate this, we conducted a secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health, which included data on delivery from 359 facilities in 29 countries. The incidence of uterine rupture among women with at least one prior CS was 0.5% (170/37,366), ranging from 0.2% in high-Human Development Index (HDI) countries to 1.0% in low-HDI countries. Factors significantly associated with uterine rupture included giving birth in medium- or low-HDI countries (adjusted odds ratio [AOR] 2.0 and 3.88, respectively), lower maternal educational level (≤6 years) (AOR 1.71), spontaneous onset of labour (AOR 1.62), and gestational age at birth <37 weeks (AOR 3....
Frequency, Predisposing Factors, and Fetomaternal Outcomes of Uterine Rupture
Journal of South Asian Federation of Obstetrics and Gynaecology, 2021
Women with ruptured uterus diagnosed prior to or during surgery at the hospital were included. Those who had ruptured uterus secondary to congenital abnormality were excluded. Data were analyzed using SPSS version 16.0. Results: There were 1,054 deliveries during the year 2019 and rupture was diagnosed in nine cases (0.8%). Two women with rupture were booked and the rest were un-booked. Neglected obstructed labor was the major cause of ruptured uteri, while 44.44% cases had previous cesarean section scar. With respect to site, 66.66% of cases had ruptured anterior wall. Rupture was complete in 77.7% of cases. Hysterectomy was performed in 44.44%. Two maternal and seven intrauterine deaths (77.78%) took place in this study. Live birth rate was 22.22%. Conclusion: Our study proved that neglected prolonged labor is still claiming maternal lives in the region. Antenatal care should be made more accessible and training should be provided to traditional birth attendants to recognize and refer such cases. Clinical significance: Traditional birth attendants need to be supervised and trained to use oxytocin. Women should be advised strictly to deliver in hospitals after a cesarean birth.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Between January 2001 to September 2003, 46,171 deliveries were recorded, the number of caesarean deliveries during this period of two years and nine months were 16,182 (35.04%). Methods: An Audit from the Institute of obstetrics and gynecology, of uterine ruptures.Results: Total 81 cases of uterine rupture were managed at the Institute. Total number of scar ruptures managed were, 48/81 uterine ruptures. Five women had previous classical upper segment caesarean, and in previous lower segment caesarean section (LSCS), there were 43 cases of rupture uterus. In two cases following forceps delivery, traumatic uterine ruptures were recorded. Spontaneous ruptures were 31 during the study period. Bladder rupture occurred in 13 cases, 16.04% of uterine ruptures. The fetal outcome in uterine ruptures 81 cases, live births were 19-23.45%. The number of vaginal births after caesarean section were 261, 215, 186 in the years 2001, 2002 and 2003 at the Institute of obstetrics and gyn...
Bjog: An International Journal Of Obstetrics And Gynaecology, 2018
Methods We merged individual data, collected prospectively in nine population-based studies, of women with complete uterine rupture, defined as complete disruption of the uterine muscle and the uterine serosa, regardless of symptoms and rupture of fetal membranes. Main outcome measures Prevalence of complete uterine rupture, regional variation and correlation with rates of caesarean section (CS) and trial of labour after CS (TOLAC). Severe maternal and perinatal morbidity and mortality. Results We identified 864 complete uterine ruptures in 2 625 017 deliveries. Overall prevalence was 3.3 (95% CI 3.1-3.5) per 10 000 deliveries, 22 (95% CI 21-24) in women with and 0.6 (95% CI 0.5-0.7) in women without previous CS. Prevalence in women with previous CS was negatively correlated with previous CS rate (q = À0.917) and positively correlated with TOLAC rate of the background population (q = 0.600). Uterine rupture resulted in peripartum hysterectomy in 87 of 864 women (10%, 95% CI 8-12%) and in a perinatal death in 116 of 874 infants (13.3%, 95% CI 11.2-15.7) whose mother had uterine rupture. Overall rate of neonatal asphyxia was 28% in neonates who survived. Conclusions Higher prevalence of complete uterine ruptures per TOLAC was observed in countries with low previous CS and high TOLAC rates. Rates of hysterectomy and perinatal death are about 10% following complete uterine rupture, but in women undergoing TOLAC the rates are extremely low (only 2.2 and 3.2 per 10 000 TOLACs, respectively.
BJOG: An International Journal of Obstetrics & Gynaecology, 2005
Objective To determine the prevalence of uterine rupture worldwide. Design Systematic review of all available data since 1990. Setting Community-based and facility-based reports from urban and rural studies worldwide. Sample Eighty-three reports of uterine rupture rates are included in the systematic review. Most are facility based using cross-sectional study designs. Methods Following a pre-defined protocol an extensive search was conducted of 10 electronic databases as well as other sources. Articles were evaluated according to specified inclusion criteria. Uterine rupture data were collected along with information on the quality of reporting including definitions and identification of cases. Data were entered into a database and tabulated using SAS software. Main outcome measures Prevalence of uterine rupture by country, period, study design, setting, participants, facility type and data source. Results Prevalence figures for uterine rupture were available for 86 groups of women. For unselected pregnant women, the prevalence of uterine rupture reported was considerably lower for community-based (median 0.053, range 0.016-0.30%) than for facility-based studies (0.31, 0.012-2.9%). The prevalence tended to be lower for countries defined by the United Nations as developed than the less or least developed countries. For women with previous caesarean section, the prevalence of uterine rupture reported was in the region of 1%. Only one report gave a prevalence for women without previous caesarean section, from a developed country, and this was extremely low (0.006%). Conclusion In less and least developed countries, uterine rupture is more prevalent than in developed countries. In developed countries most uterine ruptures follow caesarean section. Future research on the prevalence of uterine rupture should differentiate between uterine rupture with and without previous caesarean section.
PloS one, 2017
To estimate the relation of single-layer closure at previous caesarean delivery, and other pre-labour and intra-partum risk factors for complete uterine rupture in trial of vaginal birth after a caesarean (TOLAC) at term. Population-based case-control study. We identified all women (n = 39 742) recorded in the Danish Medical Birth Registry (DMBR) during a 12-year period (1997-2008) with a singleton pregnancy at term and TOLAC. Among these, all women with a complete uterine rupture were identified (cases). Information from the registry was validated against medical records. Controls were selected in the DMBR as the following two births with TOLAC at term and no uterine rupture. Detailed information from cases and controls was collected from manual review of medical records. Main outcome measure was complete uterine rupture during TOLAC at term. Upon validation, 175 cases and 272 controls met the above criteria. After adjustment for possible confounding factors there was no associatio...
A retrospective analysis of uterine rupture
Background:Uterine rupture is a rare obstetrical complication associated with disastrous outcome. Since the rate of caesarean deliveries has increased in the past decades, the risk of scar rupture is also expected to increase. The incidence of uterine rupture is inversely proportional to quality of obstetric care being provided. In the developing world, uterine rupture can have devastating maternal and/or fetal outcomes due to delayed recognition and/or intervention Materials and Methods:This is a retrospective study of patients with uterine rupture from January 2017 to December 2017, admitted in Rajendra Institute of Medical Sciences, Ranchi in the Department of Obstetrics and Gynecology. All the cases of uterine rupture were included and detailed study of their case history, obstetric history, surgical history was done. Details of their referral, duration & augmentation of labor, diagnosis on admission, site of rupture, surgical intervention requiring hysterectomy or repair and fetomaternal outcome were recorded Results: Risk factors identified in this study which predispose to uterine rupture include multiparity, obstruction, malpresentation, injudicious use of oxytocis. Short inter-pregnancy interval in case of a repeat cesarean section is also an important factor. Uterine rupture was more common in unbooked cases and woman belonging to rural areas. Conclusion:It's important to focus on improving antenatal care, contraception counselling and awareness, mandatory institutional deliveries in post caesarean pregnancies and timely referral of prolonged/obstructed labor.
Archives of Gynecology and Obstetrics, 2011
Purpose To determine the risk of uterine rupture for women undergoing trial of labour (TOL) with both a prior caesarean section (CS) and a vaginal delivery. Methods A systematic literature search was performed using keywords for CS and uterine rupture. The results were critically appraised and the data from relevant and valid articles were extracted. Odds ratios were calculated and a pooled estimate was determined using the Mantel-Haenszel method. Results Five studies were used for final analysis. Three studies showed a significant risk reduction for women with both a previous CS and a prior vaginal delivery (PVD) compared to women with a previous CS only, and two studies showed a trend towards risk reduction. The absolute risk of uterine rupture with a prior vaginal delivery varied from 0.17 to 0.46%. The overall odds ratio for PVD was 0.39 (95% CI 0.29-0.52, P \ 0.00001). Conclusion Women with a history of both a CS and vaginal delivery are at decreased risk of uterine rupture when undergoing TOL compared with women who have only had a CS.
Uterine Rupture: Changing Trends in Obstetrics and Lessons for Obstetricians
Journal of SAFOG with DVD, 2012
Objectives To determine the impact of improved obstetric care on the incidence, risk factors, management modalities and fetomaternal outcome of uterine rupture. Materials and methods Retrospective analysis of clinical records of uterine rupture cases at the department of Obstetrics and Gynecology, Abha General Hospital, Abha, KSA, from January 2007 to January 2012. Outcome measures Maternal and perinatal morbidity and mortality. Results Analysis showed 33 cases of uterine rupture among 34,590 deliveries, the incidence being 1/1048 (0.09%). Majority of the cases (73%) were unbooked. Important risk factors were previous cesarean section (88%) and grand multiparity (80%). Previous one C-section was also found to be an important risk factor (80%) for uterine rupture. Most of the patients were in their 30s. The frequency of complete and incomplete uterine rupture was almost the same (52 and 48% respectively). Total abdominal hysterectomy was required in 9 (27%), repair in 23 (70%) and on...