Uterine Rupture by Intended Mode of Delivery in the UK: A National Case-Control Study

Abstract

A case-control study using UK data estimates the risk of uterine rupture in subsequent deliveries amongst women who have had a previous caesarean section.

Beyond maternal death: improving the quality of maternal care through national studies of ‘near-miss’ maternal morbidity

“…Cases included in the analysis of socioeconomic inequalities were women who suffered from one of the following six conditions of severe maternal morbidity directly attributable to pregnancy causes: AFE, 32 AFLP, 30 eclampsia, 28 peripartum hysterectomy, 31 peripartum haemorrhage 129 and uterine rupture. 181 For the ethnic inequality study, in addition to these six conditions, cases were included from a further five conditions: antenatal pulmonary embolism, 29 stroke in pregnancy, 74 placenta accreta, 72 HELLP syndrome 54 and severe sepsis. 99 These data sets represented the entirety of data available on direct maternal morbidities and control women at the time the analyses were conducted.…”

“…This represents only a summary of key points; many more specific messages for care are reported in the publications about individual conditions and these should be referred to for further detail. 54,71,72,181,220,221 The incidence of the specific morbidities most commonly leading to maternal death in the UK We examined the incidence of AFE, severe maternal sepsis, uterine rupture, HELLP syndrome and placenta accreta/increta/percreta. Because the studies conducted were national cohort or case-control studies, we were able to estimate incidence of each condition with a relatively high degree of precision.…”

“…The incidence of uterine rupture among women with a previous caesarean section planning vaginal delivery who labour spontaneously is 1 in 800, compared with 1 in 330 among women who are induced or augmented. 181 The incidence of placenta accreta/increta/percreta can also be estimated among different subgroups of women. Women without a placenta praevia and who have not had a previous caesarean delivery have an estimated incidence of placenta accreta/increta/percreta of 1 in 33,000, women who had a previous caesarean delivery but who do not have a placenta praevia have an estimated incidence of 1 in 3300, and DOI: 10.3310/pgfar04090 PROGRAMME GRANTS FOR APPLIED RESEARCH 2016 VOL.…”

Impact of Janani Suraksha Yojana on institutional delivery rate, incidence of rupture uterus and feto-maternal outcome related to uterine rupture

“…But this remaining incidence 1.14% is still very high in comparison to other countries as 0.02% in UK (Fitzpatrick et al), 0.0521% in China (Xiaoxia B et al), 0.67% in Pakistan (Nousheen et al), 0.85% in northern Nigeria (Akaba GO et al), 0.225% in Tanzania (Kidanto HL et al), 1.46% in southern Nigeria (Kelechi et al) and even other parts of India also as 0.07% in Mumbai (Nagarkatti RS et al). [7][8][9][10][11][12] We have observed that rupture uterus occurred much more frequently in unscarred uterus in our study group even after implementation of JSY. This might be due to deliveries conducted by untrained personnel in rural sectors where either proper medical care is still not available or the ill-informed, uneducated patient and family are still reluctant to seek any trained help.…”

“…But the remaining maternal mortality (4.88%) is still higher in comparison to the studies like Xiaoxia B et al (0%), Fitzpatrick et al (1.3%) and lower to studies Akaba et al (14.7%), Nousheen et al (8.19%), Hussain L et al (6.6%). [7][8][9][10] We have observed that perinatal mortality was almost same in both groups i.e 93.93% and 95.12% in group 1 and group 2 respectively. This incidence of fetal case fatality rate is comparable to Akaba et al (90.7%), Kidanto H. L. et al (96.3%) and Nousheen et al (83.6%).…”