Analysis of uterine rupture cases at a tertiary referral center:  A retrospective study

Karaman, Erbil; Çim, Numan; Cetin, Orkun; Alkış, İsmet; Kolusarı, Ali; Yıldızhan, Recep; Güler, Hnım Şahin

doi:10.5505/vtd.2016.87597

Cited by 1 publication

(1 citation statement)

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“…Grand multiparity defined as parity 5 and above, can also increase the risk of uterine rupture [12], [13]. In developed countries, the incidence of grand multiparity is 3–4% of all births [14], but it varies between 10–33.64% in developing countries with higher rates in Islamic countries [15], [16], [17].Grand multiparity can increase antenatal and intra-partum maternal complications, such as, anaemia, hypertensive disorders, preterm labour, postpartum haemorrhage resulting in severe maternal morbidity [18], fetal macrosomia, Diabetes mellitus [19], perinatal mortality [20].…”

Section: Introductionmentioning

confidence: 99%

The Mode of delivery of grand multiparous with post-cesarean single uterine scar in low resources settings: A retrospective cohort study

Valère

Belinga

Adolphe

et al. 2019

European Journal of Obstetrics & Gynecology and Reproductiv

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The prevalence of post-caesarean scar uterus, the most important risk factor of uterine rupture is increasing globally. Grand multiparity can also increase the risk of uterine rupture. The issue of grand multiparous with single post caesarean scar is poorly investigated. Objectives The purpose of this study was to assess the factors associated with the mode of delivery of grand multiparous with post caesarean single uterine scar in low resources settings. Patients and Method It was a retrospective cohort study conducted from the 1 st January to the 31 st of May 2016, in three university teaching hospitals of the university of Yaoundé I in Cameroon. Grand multiparous (GMP) defined as parity ≥5 with single post-caesarean lower segment uterine scar admitted at a gestational age of 37 completed weeks and above were compared to grand multiparous without scar uterus at term. GMP with unknown scar were excluded. The mode of delivery and materno-fetal and neonatal outcome were investigated. Results We included 33 GMP with single lower segment uterine scar and 120 GMP without uterine scar. Induction of labor and acute fetal distress were not related to having a scar or not in grand GMP, but augmentation of labor was less likely to be conducted in case of GMP with scar uterus(p = 0.08). The frequency of vaginal delivery was 75.8 and 87.5% in grand multiparous with and without uterine scar respectively (OR 0.17–1.16; P = 0.085), with one case of instrumental delivery in scarless group. However, single scar multiparity status increased by 2.42 folds the risk of delivery by caesarian section (P = 0.066). Cephalo-pelvic disproportion increased the indication of caesarian section by 12-fold in the GMP with scar group (p = 0.031), but mechanical dystocia related indications (CPD, macrosomia,) were present in only 4 cases out of 8 caesarian sections in the exposed group. The Apgar score at the fifth minute was better in the GMP with scar group. (p = 0.037). Conclusion Grand multiparous with single post-cesarean uterine scar should be given a chance of vaginal delivery in the absence added feto-maternal morbidity.

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