Uterine scar rupture - Prediction, prevention, diagnosis, and management

Tanos, Vasilios; Toney, Zara Abigail

doi:10.1016/j.bpobgyn.2019.01.009

Cited by 99 publications

(91 citation statements)

References 70 publications

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“…Uterine rupture is a rare 0.07% 7 obstetric complication worldwide 8 but it is a serious life-threatening which can adversely affect subsequent pregnancies 9 , and associated with significant and high maternal and fetal morbidity and mortality. It is one of the major public health concerns 2 , 10 with 33% of maternal fatality rate and 52% of perinatal mortality rate 11 , 12 .…”

Section: Introductionmentioning

confidence: 99%

Prevalence and determinants of uterine rupture in Ethiopia: a systematic review and meta-analysis

Alemu

Bitew

Gelaw

et al. 2020

Sci Rep

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Uterine rupture is a serious public health concern that causes high maternal and perinatal morbidity and mortality in the developing world. Few of the studies conducted in Ethiopia show a high discrepancy in the prevalence of uterine rupture, which ranges between 1.6 and 16.7%. There also lacks a national study on this issue in Ethiopia. This systematic and meta-analysis, therefore, was conducted to assess the prevalence and determinants of uterine rupture in Ethiopia. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic review and meta-analysis of studies. All observational published studies were retrieved using relevant search terms in Google scholar, African Journals Online, CINHAL, HINARI, Science Direct, Cochrane Library, EMBASE and PubMed (Medline) databases. Newcastle–Ottawa assessment checklist for observational studies was used for critical appraisal of the included articles. The meta-analysis was done with STATA version 14 software. The I2 test statistics were used to assess heterogeneity among included studies, and publication bias was assessed using Begg's and Egger's tests. Odds ratio (OR) with a 95% confidence interval (CI) was presented using forest plots. A total of twelve studies were included in this study. The pooled prevalence of uterine rupture was 3.98% (95% CI 3.02, 4.95). The highest (7.82%) and lowest (1.53%) prevalence were identified in Amhara and Southern Nations, Nationality and Peoples Region (SNNPR), respectively. Determinants of uterine rupture were urban residence (OR = 0.15 (95% CI 0.09, 0.23)), primipara (OR = 0.12 (95% CI 0.06, 0.27)), previous cesarean section (OR = 3.23 (95% CI 2.12, 4.92)), obstructed labor(OR = 12.21 (95% CI 6.01, 24.82)), and partograph utilization (OR = 0.12 (95% CI 0.09, 0.17)). Almost one in twenty-five mothers had uterine rupture in Ethiopia. Urban residence, primiparity, previous cesarean section, obstructed labor and partograph utilization were significantly associated with uterine rupture. Therefore, intervention programs should address the identified factors to reduce the prevalence of uterine rupture.

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Section: Introductionmentioning

confidence: 99%

Prevalence and determinants of uterine rupture in Ethiopia: a systematic review and meta-analysis

Alemu

Bitew

Gelaw

et al. 2020

Sci Rep

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“…Vaginal birth after cesarean (VBAC) may be desired by some women, but the patient-level benefits associated with VBAC including avoiding repeat abdominal surgery and risk of complications in future pregnancies must be considered against the potential risks of a failed trial of labor after cesarean (TOLAC) with subsequent maternal and neonatal morbidity, including an unplanned repeat CD [18]. While the risk for uterine rupture of the previous cesarean incision scar is low (single CD 0.72%; double CD 1.59%) there is maternal and neonatal risk [21].…”

Section: Introductionmentioning

confidence: 99%

Clinical interventions that influence vaginal birth after cesarean delivery rates: Systematic Review & Meta-Analysis

Wingert

Hartling

Sebastianski

et al. 2019

BMC Pregnancy Childbirth

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BackgroundTo systematically review the literature on clinical interventions that influence vaginal birth after cesarean (VBAC) rates.MethodsWe searched Ovid Medline, Ovid Embase, Wiley Cochrane Library, CINAHL via EBSCOhost; and Ovid PsycINFO. Additional studies were identified by searching for clinical trial records, conference proceedings and dissertations. Limits were applied for language (English and French) and year of publication (1985 to present). Two reviewers independently screened comparative studies (randomized or non-randomized controlled trials, and observational designs) according to a priori eligibility criteria: women with prior cesarean sections; any clinical intervention or exposure intended to increase the VBAC rate; any comparator; and, outcomes reporting VBAC, uterine rupture and uterine dehiscence rates. One reviewer extracted data and a second reviewer verified for accuracy. Meta-analysis was conducted using Mantel-Haenszel (random effects model) relative risks (VBAC rate) and risk differences (uterine rupture and dehiscence). Two reviewers independently conducted methodological quality assessments using the Mixed Methods Appraisal Tool (MMAT).ResultsTwenty-nine studies (six trials and 23 cohorts) examined different clinical interventions affecting rates of vaginal deliveries among women with a prior cesarean delivery (CD). Methodological quality was good overall for the trials; however, concerns among the cohort studies regarding selection bias, comparability of groups and outcome measurement resulted in higher risk of bias. Interventions for labor induction, with or without cervical ripening, included pharmacologic (oxytocin, prostaglandins, misoprostol, mifepristone, epidural analgesia), non-pharmacologic (membrane sweep, amniotomy, balloon devices), and combined (pharmacologic and non-pharmacologic). Single studies with small sample sizes and event rates contributed to most comparisons, with no clear differences between groups on rates of VBAC, uterine rupture and uterine dehiscence.ConclusionsThis systematic review evaluated clinical interventions directed at increasing the rate of vaginal delivery among women with a prior CD and found low to very low certainty in the body of evidence for cervical ripening and/or labor induction techniques. There is insufficient high-quality evidence to inform optimal clinical interventions among women attempting a trial of labor after a prior CD.

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“…Recent domestic reports showed similar VBAC rate, ranging from 76.7%–87.2% (Li et al, ; Xing et al, ; Yang et al, ). In contrast to the rates reported in a literature review between 60%–77% (Tanos & Toney, ), the relatively higher outcome might be caused by the times of previous C‐S. For our research, only those who had once C‐S could choose TOLAC.…”

Section: Discussionmentioning

confidence: 60%

“…Recent domestic reports showed similar VBAC rate, ranging from 76.7%-87.2% (Li et al, 2019;Xing et al, 2019;. In contrast to the rates reported in a literature review between 60%-77% (Tanos & Toney, 2019) Our midwifery clinic aims at a caseload model to provide antepartum care for first, second and third trimester so that assessment and guidance can fit in the characteristics of each period. According to Whitelaw, Bhattacharya, McLernon, and Black (2014), women searching for internet on VBAC were exposed to limited information, thus providing personalised and full consult is important for the clients.…”

Section: Discussionmentioning

confidence: 95%

Using healthcare failure mode and effect analysis as a method of vaginal birth after caesarean section management

Liu

Zhu

et al. 2019

Journal of Clinical Nursing

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Aims and objectives This research was conducted to explore the effectiveness of employing the healthcare failure mode and effect analysis method in the management of trial of labour after caesarean, with the aims of increasing vaginal birth after caesarean section rate and reducing potential risks that might cause severe complications. Background Previously high caesarean section rate in China and the “two children” policy leads to the situation where multiparas are faced with the choice of another caesarean or trial of labour after caesarean. Despite evidences showing the benefits of vaginal birth after caesarean, obstetricians and midwives in China tend to be conservative due to limited experience and insufficient clinical routines. Thus, its management needs further optimisation in order to make the practice safe and sound. Design A prospective quality improvement programme using the healthcare failure mode and effect analysis. Methods With the structured methodology of healthcare failure mode and effect analysis, we determined core processes of antepartum and intrapartum management, conducted risk priority numbers and devised remedial protocols for failure modes with high risks. The programme was then implemented as a clinical routine under the agreement of the institutional review board and vaginal birth after caesarean success rates were compared before and after the quality improvement programme, both descriptively and statistically. Standards for Quality Improvement Reporting Excellence 2.0 checklist was chosen on reporting the study process. Results Seventy failure modes in seven core processes were identified in the management process, with 14 redressed for actions. The 1‐year follow‐up trial of labour after caesarean and vaginal birth after caesarean rate was increased compared with the previous 3 years, with a vaginal birth after caesarean rate of 86.36%, whereas the incidence of uterine rupture was not compromised. Conclusions The application of healthcare failure mode and effect analysis can not only promote trial of labour after caesarean and vaginal birth after caesarean rate, but also maintaining a low risk of uterine rupture. Relevance to clinical practice This modified vaginal birth after caesarean management protocol has been shown effective in increasing its successful rate, which can be continued for further comparison of severe complications to the previous practice.

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Uterine scar rupture - Prediction, prevention, diagnosis, and management

Cited by 99 publications

References 70 publications

Prevalence and determinants of uterine rupture in Ethiopia: a systematic review and meta-analysis

Prevalence and determinants of uterine rupture in Ethiopia: a systematic review and meta-analysis

Clinical interventions that influence vaginal birth after cesarean delivery rates: Systematic Review & Meta-Analysis

Using healthcare failure mode and effect analysis as a method of vaginal birth after caesarean section management

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