Risk factors and outcomes associated with type of uterine rupture.

Female Pregnancy Humans Uterine Rupture / epidemiology Vaginal Birth after Cesarean / adverse effects Cesarean Section, Repeat / adverse effects Retrospective Studies Trial of Labor Risk Factors
Cesarean delivery Complete uterine rupture Elective repeat cesarean delivery Feto-maternal outcome Trial of labor after cesarean Vaginal birth after cesarean

Journal

Archives of gynecology and obstetrics
ISSN: 1432-0711
Titre abrégé: Arch Gynecol Obstet
Pays: Germany
ID NLM: 8710213

Informations de publication

Date de publication:
12 2022
Historique:
received: 14 03 2021
accepted: 10 02 2022
pubmed: 15 3 2022
medline: 8 11 2022
entrez: 14 3 2022
Statut: ppublish

Résumé

To identify risk factors associated with the occurrence of complete uterine rupture (CUR) in comparison to partial uterine rupture (PUR) to further investigate to what extent a standardized definition is needed and what clinical implications can be drawn. Between 2005 and 2017 cases with CUR and PUR at Charité University Berlin, Germany were retrospectively identified. Demographic, obstetric and outcome variables were analyzed regarding the type of rupture. Binary multivariate regression analysis was conducted to identify risk factors associated with CUR. In addition, the intended route of delivery (trial of labor after cesarean delivery (TOLAC) and elective repeat cesarean delivery (ERCD)), divided according to the type of rupture, was compared. 92 cases with uterine rupture were identified out of a total of 64.063 births (0.14%). Puerperal complications were more frequent in CUR (67.9 versus 41.1%, p = 0.021). Multiparity ≥ 3 was more frequent in CUR (31 versus 10.7%, p = 0.020). Factors increasing the risk for CUR were parity ≥ 3 (OR = 3.8, p = 0.025), previous vaginal birth (OR = 4.4, p = 0.011), TOLAC (OR = 6.5, p < 0.001) and the use of oxytocin (OR = 2.9, p = 0.036). After multivariate analysis, the only independent risk factor associated with CUR was TOLAC (OR = 7.4, p = 0.017). TOLAC is the only independent risk factor for CUR. After optimized antenatal counselling TOLAC and ERCD had comparable short-term maternal and fetal outcomes in a high resource setting. A high number of previous vaginal births does not eliminate the risk of uterine rupture. A clear distinction between CUR and PUR is essential to ensure comparability among studies.

Identifiants

DOI: 10.1007/s00404-022-06452-0 PMID: 35284959 PMC: PMC9633527
pubmed: 35284959
doi: 10.1007/s00404-022-06452-0
pii: 10.1007/s00404-022-06452-0
pmc: PMC9633527
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1967-1977

Informations de copyright

© 2022. The Author(s).

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Auteurs

D Dimitrova (D)

Department of Obstetrics and Department of Gynecology With Center for Oncological Surgery, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. desislava.dimitrova@charite.de.
Department of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. desislava.dimitrova@charite.de.
ORCID: 0000-0003-4228-5158

A L Kästner (AL)

Department of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.

A N Kästner (AN)

Department of Surgery, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.

A Paping (A)

Department of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.

W Henrich (W)

Department of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.

T Braun (T)

Department of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Department of Experimental Obstetrics, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.

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Classifications MeSH

questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques de la reproduction › Reproduction › Grossesse › Risk factors and outcomes associated with type...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Risk factors and outcomes associated with type...
questionsmedicales.fr › Plaies et blessures › Rupture › Rupture utérine › Risk factors and outcomes associated with type...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie obstétrique › Accouchement (procédure) › Accouchement par voie vaginale après césarienne › Risk factors and outcomes associated with type...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie obstétrique › Accouchement (procédure) › Césarienne › Césarienne itérative › Risk factors and outcomes associated with type...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Risk factors and outcomes associated with type...
questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques de la reproduction › Reproduction › Grossesse › Travail obstétrical › Épreuve du travail › Risk factors and outcomes associated with type...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › Facteurs de risque › Risk factors and outcomes associated with type...