| Uterine rupture and subsequent pregnancy outcome--how safe is it? A 25-year study. | |
| | |
MedLine Citation:
|
PMID: 20230321 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: (a) To review the cases of ruptured uterus over the last 25 years and analyze the causative factors with a view to its prevention (b) To analyze subsequent pregnancy outcome with a view to its safety. METHOD: The case notes were reviewed for all patients with ruptured uterus over a period of 25 years from January 1982 to January 2007. Relevant dates relating to the characteristics of labor, delivery, maternal, perinatal, and subsequent pregnancy outcomes were assessed. RESULTS: The incidence of ruptured uteri was calculated to be 0.03%. Total deliveries included in the study were 152,426. There were 46 cases of ruptured uteri and 44 were available for study. Twenty-two (52%) ruptured uteri occurred in patients with previous caesarean scars, of which 10 occurred in women with previous four or more caesarean sections. In 12 cases (27%), uterine rupture occurred due to oxytocin; PGE2 and oxytocin were used in 3 of these 12 cases. Two (4.5%) ruptures occurred due to non-removal of cervical cerclage during labor. Two (4.5%) primigravidae ruptured their uterus following road traffic accident, resulting in maternal and fetal deaths. Malpresentation in labor resulted in eight (18%) ruptures. Rupture occurred at the fundus in 10 cases and in the lower segment in the remaining 34. Fetal heart abnormalities were observed in all cases in which the uterus ruptured during labor. Abdominal hysterectomy was performed in 20 cases (45%) of which 13 were subtotal and 7 (10%) were total. Of the remaining 24 (55%) patients, 10 had suture repair and in addition 14 patients underwent hypogastric artery ligation. Later, 22/24 (92%) women became pregnant. Twenty (91%) were delivered by planned caesarean section. There were no maternal or fetal complications. The remaining two women had previous classical scar, undetected malpresentation, and sparse antenatal care. Their uteri ruptured spontaneously at 32 and 35 weeks at home. They died intra-operatively due to intractable hemorrhage along with their fetus. CONCLUSION: In the previous caesarean section, the indiscriminate use of oxytocin and malpresentation are the risk factors for uterine rupture. Child birth after uterine rupture is not to be recommended routinely. Most women with a previous uterine rupture with meticulous tertiary level antenatal care had a favorable outcome in subsequent pregnancies. |
| | |
Authors:
|
Rachana Chibber; Eyad El-Saleh; Raedah Al Fadhli; Waleed Al Jassar; Jehad Al Harmi |
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: 23 ISSN: 1476-4954 ISO Abbreviation: J. Matern. Fetal. Neonatal. Med. Publication Date: 2010 May |
Date Detail:
|
Created Date: 2010-04-09 Completed Date: 2010-09-01 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101136916 Medline TA: J Matern Fetal Neonatal Med Country: England |
Other Details:
|
Languages: eng Pagination: 421-4 Citation Subset: IM |
Affiliation:
|
Faculty of Medicine, Department of Obstetrics and Gynecology, Kuwait University, Kuwait, Saudi Arabia. rachana_chibber@yahoo.co.uk |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Cicatrix / complications, epidemiology Female Fetal Mortality Gynecologic Surgical Procedures / utilization Humans Incidence Infant, Newborn Labor Presentation Middle Aged Oxytocin / adverse effects, therapeutic use Pregnancy Pregnancy Complications / epidemiology, mortality Pregnancy Outcome / epidemiology* Retrospective Studies Risk Factors Safety Uterine Rupture / epidemiology*, etiology, mortality, rehabilitation* Young Adult |
| Chemical | |
Reg. No./Substance:
|
50-56-6/Oxytocin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Probability of breech presentation and its significance.
Next Document: Physical activity during pregnancy is associated with reduced fasting insulin--the Pilot Pregnancy a...