Risk factors associated with uterine rupture during trial of labor after cesarean delivery: A case-control study

Leung, Anna S.; Farmer, Richard M.; Leung, Eleanor K.; Medearis, Arnold L.; Paul, Richard H.

doi:10.1016/s0002-9378(11)90765-0

Cited by 139 publications

(55 citation statements)

References 6 publications

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“…Most published series of women attempting TOS have demonstrated a probability of VBAC of 60-80% [5][6][7][8][9]. The higher rates in our study could be attributed to the larger number of women with higher parity (2)(3)(4) in the study population. There is consistent evidence to show that a prior vaginal delivery and, particularly, a prior VBAC are associated with a higher rate of successful trial of labour (TOL) compared with patients with no prior vaginal delivery [5,10,11].…”

Section: Discussionmentioning

confidence: 56%

See 1 more Smart Citation

Pregnancy Outcome in Women with Previous One Cesarean Section

Balachandran

Vaswani

Mogotlane

2014

JCDR

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Section: Discussionmentioning

confidence: 56%

“…Additionally, in one study evaluating risk factors for uterine rupture, no significant association was found with the presence of an unknown scar [4].…”

Section: Discussionmentioning

confidence: 96%

Pregnancy Outcome in Women with Previous One Cesarean Section

Balachandran

Vaswani

Mogotlane

2014

JCDR

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“…In an effort to aid this process, investigators have studied the different factors that are associated with the occurrence of uterine rupture. [2][3][4][5] The identification of factors associated with uterine rupture may allow physicians to provide general guidance to a woman regarding her chance of uterine rupture during a TOL. However, even though certain factors may be associated with uterine rupture, it does not necessarily follow that those associations can be combined to allow accurate prediction of the probability of a uterine rupture for an individual woman.…”

mentioning

confidence: 99%

Prediction of uterine rupture associated with attempted vaginal birth after cesarean delivery

Grobman

Lai

Landon

et al. 2008

American Journal of Obstetrics and Gynecology

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Objective-To predict individual-specific risk of uterine rupture during an attempted vaginal birth after cesarean (VBAC).Methods-Women with one prior low-transverse cesarean delivery who underwent a trial of labor with a term singleton were identified in a multi-center concurrently collected database of deliveries occurring during a four-year period. We analyzed different techniques to develop an accurate prediction model for uterine rupture.Results-Of the 11,855 women analyzed, 83 (0.7%) had a uterine rupture. The optimal model, based on a logistic regression,included: any prior vaginal delivery (OR 0.44, and labor induction(OR 1.73, 95% CI 1.11 -2.69). This model, with a c-statistic of .627, had poor discriminating ability and does not allow the determination of a clinically useful estimate of the probability of uterine rupture for an individual patient.Conclusion-Patient-specific factors cannot be used to accurately predict the relatively small proportion of women who will incur a uterine rupture during an attempted VBAC after 36 weeks of gestatation.Condensation-Factors available before or at admission for delivery cannot be used to accurately predict uterine rupture during an attempted vaginal birth after cesarean. Keywords prediction; uterine rupture; vaginal birth after cesarean Even though uterine rupture during an attempted vaginal birth after cesarean (VBAC) occurs infrequently, the potential ramifications, such as hysterectomy and neonatal neurodevelopmental disability or death, are of great clinical significance. 1 Correspondingly, when pregnant women with a prior cesarean delivery are confronted with the decision of whether to attempt a trial of labor (TOL), the possibility of a uterine rupture is particularly relevant to their decision-making process. In an effort to aid this process, investigators have studied the different factors that are associated with the occurrence of uterine rupture. 2-5The identification of factors associated with uterine rupture may allow physicians to provide general guidance to a woman regarding her chance of uterine rupture during a TOL. However, even though certain factors may be associated with uterine rupture, it does not necessarily follow that those associations can be combined to allow accurate prediction of the probability of a uterine rupture for an individual woman. The development of such a prediction model could further aid women and their caregivers in counseling regarding the decision to attempt a VBAC.Macones et al attempted to develop a model for the prediction of uterine rupture, but were unable to construct an accurate one. 6 We have recently demonstrated a methodological technique for developing a graphical nomogram that can be used to accurately predict the probability of another important component of the decision to undergo a TOL, namely, the chance of achieving a vaginal delivery. 7 We hypothesized that this technique also could allow the development of an accurate prediction model for uterine rupture. In this study, we have investigated t...

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“…Se ha comprobado que el uso excesivo de oxitocina incrementa el riesgo de ruptura uterina por lo que ocasiona complicaciones durante el parto que conllevan a la muerte del producto y de la madre. 6,12 Se ha normado que la atención perinatal debe iniciar tan pronto como se confirme el diagnóstico de embarazo y que la vigilancia del embarazo de alto riesgo merece modificaciones de acuerdo con la aparición de complicaciones y factores particulares; para disminuir el riesgo de complicación de muerte perinatal el promedio de consultas en México durante el embarazo normal es de cinco. 21 Este estudio reporta incrementó de 4.4 veces mas riesgo de muerte perinatal cuando el número de consultas prenatales es mayor a cinco, dato que pudiera resultar de: incremento en el riesgo y la necesidad percibida o sentida por la paciente, la deficiente calidad en el control prenatal.…”

Section: Discussionunclassified

Factores asociados a mortalidad perinatal en el hospital general de Chiapas, México

et al. 2003

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Resumen ObjetivoEl objetivo del estudio es identificar factores socioeconómicos, gineco-obstétricos y del producto asociados a mortalidad perinatal. Métodos Se realizó un estudio de casos y controles pareado. Se consideró caso a los nacidos vivos o muertos que nacieron y fallecieron entre las 28 semanas de gestación a los 7 días de vida extrauterina. y control al producto nacido vivo entre las 28 semanas de gestación y los 7 días de vida extrauterina. Los datos se obtuvieron de los expedientes clínicos hospitalarios. Se estudiaron 99 casos y 197 controles. Se hizo un análisis estadístico utilizando Stata 6.0. Resultados La media de edad de la madre fue de 24.82 años y del producto de 37.78 semanas de gestación. El promedio de peso del producto fue de 2,760 gramos. Los factores asociados a mortalidad perinatal fueron: ocupación del padre agricultor (RM ajustada 3,31; IC 95% 1,26-8,66); índice de riesgo obstétrico alto (RM ajustada 10,57; IC 95% 2,82-39,66), antecedente de cesárea (RM ajustada 2,75; IC 95% 1,37-5,51); cinco y más consultas prenatales (RM ajustada 4,43; IC 95% 1.86-10,54); producto pretérmino (RM ajustada 9,20; IC 95% 4,25). Conclusiones Los resultados muestran que es necesario implementar medidas de prevención y control que aseguren la identificación del riesgo en las mujeres embarazadas, con el fin de abatir la incidencia de mortalidad perinatal. Abstract Objective

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Risk factors associated with uterine rupture during trial of labor after cesarean delivery: A case-control study

Cited by 139 publications

References 6 publications

Pregnancy Outcome in Women with Previous One Cesarean Section

Pregnancy Outcome in Women with Previous One Cesarean Section

Prediction of uterine rupture associated with attempted vaginal birth after cesarean delivery

Factores asociados a mortalidad perinatal en el hospital general de Chiapas, México

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