Document Detail


Single- versus double-layer uterine incision closure and uterine rupture.
MedLine Citation:
PMID:  17118738     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate whether closure of the uterine incision with one or two layers changes uterine rupture or vaginal birth after cesarean section (VBAC) success rates. METHODS: Subjects with one previous cesarean section by documented transverse uterine incision that attempted VBAC were identified. Exclusion criteria included lack of documentation of the type of closure of the previous uterine incision, multiple gestation, more than one previous cesarean section, and previous scar other than low transverse. Uterine rupture and VBAC success rates were compared between those with single-layer and double-layer uterine closure. Time interval between deliveries, birth weight, body mass index (BMI), and history of previous VBAC were evaluated as possible confounders. RESULTS: Of 948 subjects identified, 913 had double-layer closure and 35 had single-layer closure. The uterine rupture rate was significantly higher in the single-layer closure group (8.6% vs. 1.3%, p = 0.015). This finding persisted when controlling for previous VBAC, induction, birth weight >4000 g, delivery interval >19 months, and BMI >29 (OR 8.01, 95% CI 1.96-32.79). There was no difference in VBAC success rate (74.3% vs. 77%, p = 0.685). CONCLUSION: Single-layer uterine closure may be more likely to result in uterine rupture.
Authors:
Cynthia Gyamfi; Gabor Juhasz; Phyllis Gyamfi; Yair Blumenfeld; Joanne L Stone
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  19     ISSN:  1476-7058     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-11-22     Completed Date:  2007-02-23     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  639-43     Citation Subset:  IM    
Affiliation:
The Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA. drcynthiagyamfi@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Cesarean Section / methods
Female
Humans
Pregnancy
Uterine Rupture / prevention & control*
Vaginal Birth after Cesarean

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