Maternal and newborn outcomes following uterine rupture among women without versus those with a prior cesarean

Barger, Mary K.; Nannini, Angela; DeJoy, Susan; Wisner, Kirsten; Markenson, Glenn

doi:10.3109/14767058.2012.725790

Cited by 22 publications

(16 citation statements)

References 16 publications

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“…Barger et al,3 consistent with our results, found that hysterectomies were significantly more frequent after ruptures in unscarred (36.1%) than scarred uteri (5.0%). In addition, they reported that severe morbidity was associated three times more frequently with ruptures in unscarred uteri than scarred uteri.…”

supporting

confidence: 93%

“…Several, but not all, observed that, compared with scarred uteri, in unscarred uteri, ruptures were associated with worse maternal outcomes, such as hysterectomy, severe postpartum hemorrhage, and maternal morbidity. [3][4][5][6][7] Previously, we described infant outcome after complete uterine rupture. 8 Here, we focus on the maternal outcome.…”

Section: Introductionmentioning

confidence: 99%

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Maternal outcome after complete uterine rupture

Al-Zirqi

Daltveit

Vangen

2019

Acta Obstet Gynecol Scand

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Introduction Complete uterine rupture, a rare peripartum complication, is often associated with a catastrophic outcome for both mother and child. However, few studies have investigated large datasets to evaluate maternal outcomes after complete ruptures, particularly in unscarred uteri. This paucity of studies is partly due to the rarity of both the event and the serious outcomes, such as peripartum hysterectomy and maternal death. The incidence of uterine rupture is expected to increase, due to increasing cesarean section rates worldwide. Thus, it is important to have more complete knowledge about the immediate maternal outcome following a complete uterine rupture. The objective was to identify maternal outcomes and their risk factors following complete uterine ruptures. Material and methods This was a population‐based study using data from the Medical Birth Registry of Norway, the Patient Administration System and medical records. Maternities with complete uterine rupture after start of labor in Norway during 1967‐2008 (n = 247 births), identified among 2 209 506 women. Uterine ruptures were identified from both registries and were further studied through a review of medical records. Only complete ruptures were included in analysis. The associations between maternal outcomes and demographic and labor risk factors were estimated. Odds ratios (ORs) were determined with crude logistic regressions for each risk factor. Separate multivariable logistic regressions were performed to calculate adjusted odds ratios and 95% confidence intervals (CIs). Results We identified 88 (35.6%) healthy mothers, 107 (43.3%) severe postpartum hemorrhages without hysterectomy, 51 (20.6%) peripartum hysterectomies, and three (1.2%) maternal deaths. Peripartum hysterectomy decreased significantly in the last years of study. Unscarred uterine ruptures significantly increased the risk of peripartum hysterectomy compared with scarred uterine ruptures (AOR 2.6, 95% CI 1.3‐5.3). Other factors that increased the risk of peripartum hysterectomy following rupture were: maternal age ≥35 years (AOR 2.3, 95% CI 1.1‐5.0), parity ≥3 vs parity 1‐2 (AOR 2.8, 95% CI 1.2‐6.7), and rupture detection after vaginal delivery (AOR 2.2, 95% CI 1.1‐4.8). Conclusions Unscarred uteri, older maternal age, parity ≥3, and rupture detection after vaginal delivery showed the highest associations with the risk of peripartum hysterectomy after complete uterine rupture.

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supporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Maternal outcome after complete uterine rupture

Al-Zirqi

Daltveit

Vangen

2019

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

show abstract

“…However, the reported frequencies of these morbid events after uterine rupture vary significantly in the literature. Blood transfusion has been reported as necessary in 12% to as high as 100% of cases . We report a rate toward the lower side.…”

Section: Discussionmentioning

confidence: 68%

“…After uterine rupture, the percentage of cases requiring hysterectomy in the literature ranges between 4% and 36% . The percentage of cases requiring ICU admission ranges between 4.5% and 33% . In more recent years, we see similar rates, still showing high relative risks.…”

Section: Discussionmentioning

confidence: 68%