Document Detail

History of cesarean before 32 weeks' gestation and trial of labor: what is the risk of uterine rupture?
MedLine Citation:
PMID:  18951216     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To estimate the risk of uterine rupture in women with a previous cesarean delivery before 32 weeks' gestation and a trial of labor. DESIGN: Retrospective case control study. Setting. Level III maternity center. METHODS: Among women with trial of labor, the case and control groups were women with previous cesarean section before and after 32 weeks, respectively. The main outcome was uterine rupture, defined as rupture of the three layers of the uterine wall. RESULTS: The study compared 108 trials of labor in patients with a previous cesarean delivery at a mean gestation of 29.8 weeks+/-2.0 SD and 137 trials of labor in patients with a previous cesarean delivery at a mean gestation of 39.2 weeks+/-2.3 SD. Mode of delivery did not differ between groups. Two uterine ruptures (1.9%, 95% CI: 0.0-4.4) occurred in the case group and none in the control group (p=0.16). Uterine ruptures caused no serious maternal or neonatal complications. The condition of the neonates was similar in the two groups. CONCLUSION: In view of the small number of uterine ruptures and the absence of severe maternal and fetal consequences over an 8-year period, a trial of labor may be proposed to women with a history of cesarean delivery before 32 weeks, when obstetrical conditions are optimal.
Sonia Estrade; Thomas Schmitz; Dominique Cabrol; Cyrille Huchon; Francois Goffinet
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  88     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2009  
Date Detail:
Created Date:  2009-01-26     Completed Date:  2009-02-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  149-53     Citation Subset:  IM    
Maternité Port-Royal, Hôpital Cochin Saint-Vincent-de-Paul, Assistance Publique-Hôpitaux de Paris, Paris, France.
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MeSH Terms
Case-Control Studies
Cesarean Section, Repeat / adverse effects*
Gestational Age
Infant, Newborn
Risk Assessment
Trial of Labor*
Uterine Rupture / etiology*

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