Trends, risk factors and pregnancy outcome in women with uterine rupture

Ronel, Dror; Wiznitzer, Arnon; Sergienko, Ruslan; Zlotnik, Alexander; Sheiner, Eyal

doi:10.1007/s00404-011-1977-8

Cited by 79 publications

(98 citation statements)

References 14 publications

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“…The relation between maternal age, parity, previous obstetric history, fetal growth, and other maternal conditions with intrapartum complications such as sentinel events or abnormal CTG has previously been explored. [26][27][28][29] In Locatelli et al used inclusion and exclusion criteria similar to ours in a hospitalbased study of 27 cases and 100 term controls. Intrapartum factors alone were found in 22% of cases and a combination of antepartum and intrapartum factors was identified in an additional 44%.…”

Section: Discussionmentioning

confidence: 99%

Antepartum and Intrapartum Factors Preceding Neonatal Hypoxic-Ischemic Encephalopathy

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Etiology and timing of onset of neonatal hypoxic-ischemic encephalopathy continue to be controversial. Previous studies suggest antepartum events are the main contributing factors, but have used a broad definition of encephalopathy and included infants with genetic, congenital, and developmental abnormalities.WHAT THIS STUDY ADDS: Our study suggests that when strict criteria defining hypoxic-ischemic encephalopathy are applied with supporting neuroimaging evidence of an acute hypoxicischemic insult, intrapartum events are the final and necessary pathway leading to this condition. abstract OBJECTIVE: To determine whether antepartum factors alone, intrapartum factors alone, or both in combination, are associated with term neonatal hypoxic-ischemic encephalopathy (HIE). METHODS:A total of 405 infants $35 weeks' gestation with early encephalopathy, born between 1992 and 2007, were compared with 239 neurologically normal infants born between 1996 and 1997. All cases met criteria for perinatal asphyxia, had neuroimaging findings consistent with acute hypoxia-ischemia, and had no evidence for a non-hypoxic-ischemic cause of their encephalopathy.RESULTS: Both antepartum and intrapartum factors were associated with the development of HIE on univariate analysis. Case infants were more often delivered by emergency cesarean delivery (CD; 50% vs 11%, P , .001) and none was delivered by elective CD (vs 10% of controls). On logistic regression analysis only 1 antepartum factor (gestation $41 weeks) and 7 intrapartum factors (prolonged membrane rupture, abnormal cardiotocography, thick meconium, sentinel event, shoulder dystocia, tight nuchal cord, failed vacuum) remained independently associated with HIE (area under the curve 0.88; confidence interval 0.85-0.91; P , .001). Overall, 6.7% of cases and 43.5% of controls had only antepartum factors; 20% of cases and 5.8% of controls had only intrapartum factors; 69.5% of cases and 31% of controls had antepartum and intrapartum factors; and 3.7% of cases and 19.7% of controls had no identifiable risk factors (P , .001). CONCLUSIONS:Our results do not support the hypothesis that HIE is attributable to antepartum factors alone, but they strongly point to the intrapartum period as the necessary factor in the development of this condition. Pediatrics 2013;132:e952-e959

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Section: Discussionmentioning

confidence: 99%

Antepartum and Intrapartum Factors Preceding Neonatal Hypoxic-Ischemic Encephalopathy

et al. 2013

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“…(5) Previous caesarean section incision or other uterine scars, uterine anomalies, grand multiparity, tumours, use of oxytocin, placenta percreta and foetal anomalies are postulated risk factors for uterine rupture. (6) Uterine scar is site for the vast majority of uterine dehiscence and rupture. The atrophic, inelastic nature of the scar renders it less adaptive to force in labour, predisposing to scar rupture.…”

Section: Discussionmentioning

confidence: 99%

“…(7) The underlying factors for UR include a poor referral system, non-attendance to antenatal care, delay in seeking medical care and delay of essential intervention. (6) Low socio-economic status, the delivery of babies > 3.5 kg, HIV positivity and history of previous caesarean section are other postulated risk factors for UR. Oxytocin stimulation and previous scars are assumed to be the direct causes of UR in developed countries, while obstructed labour is the main culprit in developing countries.…”

Section: Discussionmentioning

confidence: 99%

Uterine Rupture at 31 Weeks and Its Outcome- A Case Report

Abraham¹,

Varghese²,

Varghese³

et al. 2017

jemds

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“…As consequências ao feto são, em geral, muito graves, uma vez que esse e a placenta são expelidos para a cavidade abdominal seguido de hipóxia e risco elevado de óbito perinatal [1][2][3] . É definida como uma solução de continuidade da espessura total da parede do útero e peritônio sobrejacente.…”

Section: Introductionunclassified

“…Vale salientar que essas diferenças não são consideradas em alguns estudos, sendo empregado o termo rotura para as duas condições 2,5 . O risco de rotura uterina é maior em alguns grupos de gestantes, sendo esses amplamente liderados pelo das mulheres com cicatriz de cesárea prévia 1,2,6,7 . Entre essas últimas, são mais suscetíveis aquelas em trabalho de parto e que apresentam fetos em apresentação anômala, desproporção cefalopélvica, trabalho de parto distócico e as submetidas à indução do trabalho de parto 1,6,[8][9][10][11] .…”

Section: Introductionunclassified

Rotura e deiscência de cicatriz uterina: estudo de casos em uma maternidade de baixo risco do sudeste brasileiro

Okido¹,

Quintana²,

Berezowski³

et al. 2014

Rev. Bras. Ginecol. Obstet.

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ResumoOBJETIVO: Analisar os casos de rotura uterina e deiscência de cicatriz uterina ocorridos em uma maternidade de baixo risco e apontar possibilidades de aprimoramento na abordagem dessas complicações. MÉTODOS: Foi realizado um estudo descritivo em uma maternidade de baixo risco com 30 leitos, que presta assistência às usuárias do sistema público de saúde. A investigação foi realizada por meio de busca dos casos em livros de registros de sala de parto e posterior leitura dos prontuários para coleta dos dados. As informações foram inseridas em formulário previamente elaborado para este estudo. Foram incluídos os casos de rotura uterina e deiscência de cicatriz uterina diagnosticados no período de 1998 a 2012, avaliados incidência, aspectos relacionados aos fatores de risco e diagnóstico, associação com o uso de misoprostol e ocitocina e desfechos observados. RESULTADOS: No período mencionado foram registrados 39.206 partos nessa instituição. A cesárea foi a conduta adotada em 10 mil partos, o que equivale a uma taxa de 25,5%. Foram identificados 12 casos de rotura uterina e 16 de deiscência de cicatriz uterina. Os resultados mais relevantes foram a alta mortalidade perinatal associada à rotura uterina e o insucesso no diagnóstico da complicação. Não foi possível demonstrar associações com o uso de misoprostol ou ocitocina. CONCLUSÃO: Os desfechos adversos da rotura uterina podem ser minimizados se esforços forem direcionados para melhorar o desempenho diagnóstico das equipes assistentes. Abstract PURPOSE:To evaluate the cases of uterine rupture and dehiscence of the uterine scar at a low-risk maternity and to point out possibilities for an improved approach to these complications. METHODS: A descriptive study was conducted at a 30-bed low-risk maternity hospital that provides care to users of the public health system. The investigation was carried out by searching for cases in the delivery room registry book and later reading the medical records in order to obtain the data. The information was inserted on a form previously elaborated for this study. Cases of uterine rupure and dehiscence of the uterine scar diagnosed from 1998 to 2012 were included, with the determination of incidence, aspects related to risk factors and diagnosis, association with the use of misoprostol and oxytocin, and the outcomes observed. RESULTS: A total of 39,206 deliveries were performed in this maternity during the study period, with 12 cases of uterine rupture and 16 cases of dehiscence of uterine scar being observed. The most relevant results were a high perinatal mortality associated with uterine rupture and the unsuccessful diagnosis of this complications. It was not possible to demonstrate an association with the use of misoprostol or oxytocin. CONCLUSION: The adverse outcomes of uterine rupture could be minimized if efforts were directed at improving the diagnostic performance of the assisting teams.

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Trends, risk factors and pregnancy outcome in women with uterine rupture

Cited by 79 publications

References 14 publications

Antepartum and Intrapartum Factors Preceding Neonatal Hypoxic-Ischemic Encephalopathy

Antepartum and Intrapartum Factors Preceding Neonatal Hypoxic-Ischemic Encephalopathy

Uterine Rupture at 31 Weeks and Its Outcome- A Case Report

Rotura e deiscência de cicatriz uterina: estudo de casos em uma maternidade de baixo risco do sudeste brasileiro

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