Abstract | OBJECTIVE: METHODS: Retrospective study of 2,128 births with a low transversal scar after a previous cesarean section. The study population was realised in a level III university hospital from 1995 to 2003. The association between mode of delivery and uterine rupture was studied in a multivariate logistic regression model, and adjusted for specific antenatal confounding factors. RESULTS: Over 9 years, we collected 22 cases (1%), including 11 asymptomatic ruptures in a population of 2,128 scarred uteri out of 28,248 deliveries. Uterine rupture occurred at a rate of 0.3 per 100 among women with repeated cesarean delivery without labour, 1 per 100 among women with spontaneous onset of labour, 1.4 per 100 among women with oxytocin-induced labour, and 2.2 per 100 among women with prostaglandin cervical ripening. Compared to women with a planned cesarean section, women with spontaneous onset of labour were more likely to have uterine rupture (OR: 4.0; 95% CI: 0.8-42.0). A greater relative risk was observed among women with oxytocin-induced labour (OR: 4.3; 95% CI: 0.3-60.0), and particularly those with prostaglandin-induced labour (OR: 8.7; 95% CI: 1.5-97.3, p=0.01). CONCLUSION: In women with a scarred uterus, prostaglandin E2 induction of labour is a risk factor for uterine rupture. The practice of a systematic cesarean section in cases with Bishop score<3, appropriate induction procedure, and rigorous monitoring of the labour, could make for a safer delivery.
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Authors | E Grossetti, D Vardon, C Creveuil, M Herlicoviez, M Dreyfus |
Journal | Acta obstetricia et gynecologica Scandinavica
(Acta Obstet Gynecol Scand)
Vol. 86
Issue 5
Pg. 572-8
( 2007)
ISSN: 0001-6349 [Print] United States |
PMID | 17464586
(Publication Type: Journal Article)
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Chemical References |
- Oxytocics
- Oxytocin
- Dinoprostone
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Topics |
- Adult
- Cicatrix
- Delivery, Obstetric
(statistics & numerical data)
- Dinoprostone
(adverse effects)
- Female
- France
(epidemiology)
- Hospitals, University
- Humans
- Incidence
- Labor, Induced
(adverse effects)
- Logistic Models
- Oxytocics
(adverse effects)
- Oxytocin
(adverse effects)
- Pregnancy
- Retrospective Studies
- Risk Factors
- Uterine Rupture
(epidemiology, etiology, prevention & control)
- Uterus
(pathology)
- Vaginal Birth after Cesarean
(adverse effects)
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