Skip to main content

Advertisement

SpringerLink
Log in

Trends, risk factors and pregnancy outcome in women with uterine rupture

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

This study aimed at determining trends, risk factors and pregnancy outcome in women with uterine rupture.

Methods

A population-based study, comparing all singleton deliveries with and without uterine rupture between 1988 and 2009 was conducted. Statistical analysis was performed using a multiple logistic regression analysis.

Results

Uterine rupture occurred in 0.06% (n = 138) of all deliveries included in the study (n = 240,189); 59% in women with a previous cesarean delivery (CD). A gradual increase in the rate of uterine rupture from 1988 (0.01%) to 2009 (0.05%) was noted. Independent risk factors for uterine rupture in a multivariable analysis were: previous CD (OR = 7.4, 95% CI 5.2–10.6), preterm delivery (<37 weeks, OR = 2.5, 95% CI 1.5–4.1), malpresentation (OR = 3.0, 95% CI 1.9–4.5), parity (OR = 1.2, 95% CI 1.1–1.3 for each birth), and dystocia during the first and second stages of labor (OR = 4.1, 95% CI 2.3–7.4 and OR = 11.2, 95% CI 6.7–18.7, respectively). Uterine rupture led to significant maternal morbidity and perinatal mortality. In another multivariable analysis, with perinatal mortality as the outcome variable uterine rupture was noted as an independent risk factor for perinatal mortality (adjusted OR = 17.7; 95% CI 10.0–31.4, P < .01).

Conclusions

Uterine rupture, associated with previous cesarean delivery, malpresentation, and labor dystocia, is an independent risk factor for perinatal mortality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Al-Zirqi I, Stray-Pedersen B, Forsén L, Vangen S (2010) Uterine rupture after previous caesarean section. BJOG 117(7):809–820

    Article  PubMed  CAS  Google Scholar 

  2. Kaczmarczyk M, Sparén P, Terry P, Cnattingius S (2007) Risk factors for uterine rupture and neonatal consequences of uterine rupture: a population-based study of successive pregnancies in Sweden. BJOG 114(10):1208–1214

    Article  PubMed  CAS  Google Scholar 

  3. Ofir K, Sheiner E, Levy A, Katz M, Mazor M (2003) Uterine rupture: risk factors and pregnancy outcome. Am J Obstet Gynecol 189(4):1042–1046

    Article  PubMed  Google Scholar 

  4. Zwart JJ, Richters JM, Ory F, De Vries JI, Bloemenkamp KW, Van Roosmalen J (2009) Uterine rupture in the Netherlands: a nationwide population-based cohort study. BJOG 116(8):1069–1078

    Article  PubMed  CAS  Google Scholar 

  5. Hamilton EF, Bujold E, McNamara H, Gauthier R, Platt RW (2001) Dystocia among women with symptomatic uterine rupture. Am J Obstet Gynecol 184(4):620–624

    Article  PubMed  CAS  Google Scholar 

  6. Grobman WA, Lai Y, Landon MB et al (2008) Prediction of uterine rupture associated with attempted vaginal birth after cesarean delivery. Am J Obstet Gynecol 199(1):30.e31–30.e35

    Article  Google Scholar 

  7. Dekker G, Chan A, Luke C, Priest K, Riley M, Halliday J, King J, Gee V, O’Neill M, Snell M, Cull V, Cornes S (2010) Risk of uterine rupture in Australian women attempting vaginal birth after one prior caesarean section: a retrospective population-based cohort study. BJOG 117(11):1358–1365

    Article  PubMed  CAS  Google Scholar 

  8. Cahill AG, Odibo AO, Allsworth JE, Macones GA (2010) Frequent epidural dosing as a marker for impending uterine rupture in patients who attempt vaginal birth after cesarean delivery. Am J Obstet Gynecol 202(4):355.e351–355.e355

    Article  Google Scholar 

  9. Zelop CM, Shipp TD, Repke JT, Cohen A, Lieberman E (2000) Effect of previous vaginal delivery on the risk of uterine rupture during a subsequent trial of labor. Am J Obstet Gynecol 183(5):1184–1186

    Article  PubMed  CAS  Google Scholar 

  10. Algert CS, Morris JM, Simpson JM, Ford JB, Roberts CL (2008) Labor before a primary cesarean delivery: reduced risk of uterine rupture in a subsequent trial of labor for vaginal birth after cesarean. Obstet Gynecol 112(5):1061–1066

    Article  PubMed  Google Scholar 

  11. Menacker F, Hamilton BE (2010) Recent trends in cesarean delivery in the United States. NCHS data brief, no 35. Centers for Disease Control and Prevention National Center for Health Statistics, Hyattsville, MD

  12. Guise JM, Denman MA, Emeis C, Marshall N, Walker M, Fu R, Janik R, Nygren P, Eden KB, McDonagh M (2010) Vaginal birth after cesarean: new insights on maternal and neonatal outcomes. Obstet Gynecol 115(6):1267–1278

    Article  PubMed  Google Scholar 

  13. Orbach A, Levy A, Wiznitzer A, Mazor M, Holcberg G, Sheiner E (2010) Peripartum cesarean hysterectomy: critical analysis of risk factors and trends over the years. J Matern Fetal Neonatal Med 24(3):480–484

    Article  PubMed  Google Scholar 

  14. Callaghan WM, Kuklina EV, Berg CJ (2010) Trends in postpartum hemorrhage: United states, 1994–2006. Am J Obstet Gynecol 202(353):e1–e6

    PubMed  Google Scholar 

  15. Ouzounian JG, Miller DA, Hiebert CJ, Battista LR, Lee RH (2011) Vaginal birth after cesarean section: risk of uterine rupture with labor induction. Am J Perinatol (epub ahead of print)

Download references

Acknowledgment

Performed in part of Dror Ronel MD requirements.

Conflict of interest

The authors report no declaration of interest, and no conflict of interest exists.

Author information

Authors and Affiliations

  1. Faculty of Health Sciences, Joyce and Irving Goldman Medical School, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Dror Ronel

  2. Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel

    Arnon Wiznitzer

  3. Epidemiology and Health Services Evaluation, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel

    Ruslan Sergienko

  4. Department of Anesthesiology and Critical Care, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel

    Alexander Zlotnik

  5. Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel

    Eyal Sheiner

Authors
  1. Dror Ronel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Arnon Wiznitzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ruslan Sergienko
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alexander Zlotnik
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eyal Sheiner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eyal Sheiner.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ronel, D., Wiznitzer, A., Sergienko, R. et al. Trends, risk factors and pregnancy outcome in women with uterine rupture. Arch Gynecol Obstet 285, 317–321 (2012). https://doi.org/10.1007/s00404-011-1977-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-011-1977-8

Keywords

Search

Navigation