Document Detail

Vaginal delivery after Misgav-Ladach cesarean section--is the risk of uterine rupture acceptable?
MedLine Citation:
PMID:  20082597     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate whether the single-layer closure as is a routine by the Misgav-Ladach method compared to the double-layer closure as used by the Dörfler cesarean method is associated with an increased risk of uterine rupture in the subsequent pregnancy and delivery.
METHODS: The analysis is retrospective and is based on medical documentation of the Clinic for Gynecology and Obstetrics, University Clinical Centre, Tuzla, Bosnia and Herzegovina. All patients with one previous cesarean section who attempted vaginal birth following cesarean section were managed from 1 January 2002 to 31 December 2008. Exclusion criteria included multiple gestation, greater than one previous cesarean section, previous incision other than low transverse, gestational age at delivery less than 37 weeks and induction of delivery. We identified 448 patients who met inclusion criteria.
RESULTS: We found that 303 patients had a single-layer closure (Misgav-Ladach) and 145 had a double-layer closure (Dörffler) of the previous uterine incision. There were 35 cases of uterine rupture. Of those patients with previous single-layer closure, 5.28% (16/303) had a uterine rupture compared to 13.11% (19/145) in the double-layer closure group (p<0.05).
CONCLUSION: We have not found that a Misgav-Ladach cesarean section method (single-layer uterine closure) might be more likely to result in uterine rupture in women who attempted a vaginal birth after a previous cesarean delivery. This cesarean section method should find its confirmation in everyday clinical practice.
Igor Hudić; Zlatan Fatusić; Lejla Kamerić; Mladen Misić; Indira Serak; Anela Latifagić
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Publication Detail:
Type:  Evaluation Studies; 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 Oct 
Date Detail:
Created Date:  2010-09-13     Completed Date:  2011-01-06     Revised Date:  2011-06-17    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1156-9     Citation Subset:  IM    
Clinic of Gynecology and Obstetrics, University Clinical Center, Tuzla, Bosnia and Herzegovina.
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MeSH Terms
Bosnia-Herzegovina / epidemiology
Cesarean Section / adverse effects*,  methods*
Retrospective Studies
Suture Techniques / adverse effects*
Uterine Rupture / epidemiology,  etiology*
Vaginal Birth after Cesarean / adverse effects*,  statistics & numerical data
Young Adult
Comment In:
J Matern Fetal Neonatal Med. 2011 Jun;24(6):870   [PMID:  21121712 ]

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