Detection of scar dehiscence at delivery in women with prior cesarean section

Gemer, Ofer; Segal, Shmuel; Sassoon, Essi

doi:10.3109/00016349209041447

Cited by 6 publications

(4 citation statements)

References 7 publications

(7 reference statements)

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“…Detection of scar dehiscence is rare with transcervical digital scar revision [28,29]. Gamer et al also reported a high risk of detection bias in a trial scoped for detecting uterine rupture by transcervical manual control [29]. Results obtained by Spaans et al [30] with uterine scar dehiscence detected mostly during cesarean section show similar pattern to this study.…”

Section: Discussionsupporting

confidence: 84%

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Safety and success rate of vaginal birth after two cesarean sections: retrospective cohort study

et al. 2019

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Objectives: Cesarean section is a lifesaving procedure with short and long-term consequences. Growing rates of cesarean sections worldwide arise problems for subsequent birth. The aim of this study was to compare safety of vaginal birth after two cesarean sections with repeat third cesarean section to help healthcare providers and patients make well informed decisions about mode of subsequent delivery. Material and methods: This was a retrospective cohort study conducted in a tertiary reference hospital. Database of all deliveries (2010-2017) after two previous cesarean sections was created from electronic and paper medical records. Preterm deliveries, abnormal karyotype and neonates with congenital anomalies were excluded from the study. The final analysis included 412 cases for maternal outcome analysis and 406 cases for neonatal outcome analysis. Results: Trial of labor after two cesareans in comparison to repeat cesarean section increases the risk of hemorrhage (OR: 10.84) and unfavorable composite maternal outcome (OR: 2.58). Failed trial of labor increases this risk of hemorrhage (OR: 15.27) and unfavorable composite maternal outcome (OR: 4.59) even further. There were no significant differences in neonatal outcomes. 22 out of 35 trials of labor ended in successful delivery giving a success rate of 62.85%. 5 of 7 labor inductions ended in repeat cesarean section giving 28.6% success rate. There were no maternal deaths and emergency hysterectomies. conclusions: Trial of labor, especially failed trial of labor, is associated with an increased risk of perinatal complications.

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Section: Discussionsupporting

confidence: 84%

“…In the studied cohort all uterine ruptures were detected during cesarean section. Detection of scar dehiscence is rare with transcervical digital scar revision [28,29]. Gamer et al also reported a high risk of detection bias in a trial scoped for detecting uterine rupture by transcervical manual control [29].…”

Section: Discussionmentioning

confidence: 99%

Safety and success rate of vaginal birth after two cesarean sections: retrospective cohort study

et al. 2019

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“…In contrast to placental removal during cesarean section [2], uterine revision is performed on a retracted uterus and this might explain in a part the lack of difference in blood loss between the 2 groups. Although a controversial procedure [3,4], systematic uterine revision did not increase infectious morbidity. On the other hand, one can argue that the diagnosis can be missed with manual exploration, and that manual exploration may also inadvertently turn a partial separation into complete dehiscence [4].…”

mentioning

confidence: 91%

“…Although a controversial procedure [3,4], systematic uterine revision did not increase infectious morbidity. On the other hand, one can argue that the diagnosis can be missed with manual exploration, and that manual exploration may also inadvertently turn a partial separation into complete dehiscence [4].…”

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confidence: 99%

Previous cesarean scar exploration following vaginal delivery and hemorrhagic morbidity

Jerbi

Hidar

Zardi

et al. 2005

International Journal of Gynecology & Obstetrics

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Manual scar exploration (or uterine revision) is routinely performed following vaginal delivery in women who underwent a previous cesarean section, although little is known about whether this procedure increases the risk of hemorrhagic scars and associated morbidity [1]. The purpose of this randomized trial was to determine whether uterine revision increased this risk.The trial was performed at the Obstetric and Gynecologic department of F. Hached Hospital, Sousse, Tunisia, after approval from the ethics committee, and all participants provided informed consent.Inclusion criteria were pregnancy duration of more than 35 weeks, vaginal delivery of a single live newborn, third stage of labor less than 30 min, and no chorioamnionitis, antepartum hemorrhage, placenta previa, or known coagulopathy.The women were assigned to 1 of 2 groups. In one group, uterine scar exploration was systematically performed after vaginal delivery; in the other group, it was performed only in women who were 0020-7292/$ -see front matter D (M. Jerbi). KEYWORDSScarred uterus; Vaginal delivery; Dehiscence Vaginal deliveries (n=5441) Vaginal birth after cesarean section (n=312) Randomly allocated management (n=130) Systematic scar exploration (n=65) Symptomatic patient scar exploration (n=65) Completed trial (n=65) Completed trial (n=65) Did not consent (n=182) Figure 1 Trial profile.

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Guidelines for client selection in the home birth midwifery practice

Vedam¹

1995

Journal of Nurse-Midwifery

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Detection of scar dehiscence at delivery in women with prior cesarean section

Cited by 6 publications

References 7 publications

Safety and success rate of vaginal birth after two cesarean sections: retrospective cohort study

Safety and success rate of vaginal birth after two cesarean sections: retrospective cohort study

Previous cesarean scar exploration following vaginal delivery and hemorrhagic morbidity

Guidelines for client selection in the home birth midwifery practice

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