Contemporary epidemiology and novel predictors of uterine rupture: a nationwide population-based study

Abstract

Despite policies implemented and changes in clinical practice, uterine rupture remains an important issue. Previously unidentified risk factors are playing now an important role, information that should be considered during patient counseling and clinical practice. Combinations of some of these factors may increase the risk of uterine rupture significantly enough to modify clinical care.

The International Network of Obstetric Survey Systems study of uterine rupture: a descriptive multi‐country population‐based study

“…In a large Norwegian register‐based study validated by review of medical records, the overall prevalence over 40 years was 1.3 (95% CI 1.2–1.5), increasing from 1.0 (95% CI 0.6–1.3) to 3.0 (95% CI 2.4–3.6) per 10 000 deliveries from the first to the last decade (2000–2008) . A large population‐based study in the USA reported a prevalence of 2.4 (95% CI 2.3–2.5) per 10 000 deliveries based on vital statistics data from 2011 to 2012 …”

“…4 A large population-based study in the USA reported a prevalence of 2.4 (95% CI 2.3-2.5) per 10 000 deliveries based on vital statistics data from 2011 to 2012. 5 We further explored the literature for population-based reports of uterine rupture in women with previous CS in high-income countries. Compared with three relatively large sources (Al-Zirqi et al, 4 Guise et al, 38 and Landon et al 7 ) reporting prevalences between 30 (95% CI 24-36) and 36 (95% CI 30-43) per 10 000 deliveries, 4,7,9 the prevalence in our study is lower, with a notably wide range between countries.…”

“…Complete uterine rupture is the disruption of the full thickness of the uterine wall, including myometrium and uterine serosa, during pregnancy or delivery . This obstetric complication is rare with prevalences between 2.4 and 3.0 per 10 000 deliveries, but is associated with severe outcomes for both mother and child. An emergency intervention is needed to prevent perinatal asphyxia and death, while the mother may suffer from life‐threatening haemorrhage and end up with peripartum hysterectomy.…”

Prevalence and predictors of uterine rupture among Ethiopian women: A systematic review and meta-analysis

“…This systematic review and meta-analysis revealed that the prevalence of uterine rupture was 2% (95% CI: 1.99%, 3.01%) at national level. This was higher than findings of 40 Low and middle income countries (LMICs) review (1%) [ 44 ], nation-wide studies conducted in United Kingdom (0.2%) [ 45 ], United States (0.02%) [ 46 ], the Netherlands (0.059%) [ 12 ], WHO systematic review (0.31%) [ 5 ], Nigeria (1.2%) [ 47 ], Uganda (0.5%) [ 48 ] and 0.67% of uterine rupture in Senegal and Mali [ 49 ]. The possible difference might be due to the variation in population characteristics, setting and quality of health care service provision and utilization.…”

Letter to the Editor: Comment on “Contemporary epidemiology and novel predictors of uterine rupture: a nationwide population-based study”

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Dear editors, I would like to thank Dr. Accordino and colleagues for their letter and interest in our study on contemporary epidemiology and novel predictors of uterine rupture [1]. I was pleased to read that Dr. Accordino and colleagues were able to identify the importance of the manuscript, as well as its implications on clinical practice.

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