Scar rupture in labour after previous lower uterine segment caesarean section: the role of uterine activity measurement

Beckley, Sarah; Gee, Harold; Newton, Richard

doi:10.1111/j.1471-0528.1991.tb13391.x

Cited by 34 publications

(13 citation statements)

References 10 publications

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“…They described loss of uterine tone during the first stage in a single case (1/36) [14]. Two small retrospective studies of Arulkumaran et al and Beckley et al found a decrease of the uterine contraction amplitude in, respectively, 33.3 % (3/9) and 40.0 % (4/10) of the uterine ruptures, which were all monitored by IUPC [26, 27]. Finally, Phelan et al observed a significantly ( p = 0.03) lower amount of contractions per hour in ruptures (15.8/h) compared with VBAC (19.7/h), monitored from the onset of active labor defined as cervical dilation of 4 cm [28].…”

Section: Resultsmentioning

confidence: 99%

Tocogram characteristics of uterine rupture: a systematic review

Vlemminx

Lau

Oei

2016

Arch Gynecol Obstet

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PurposeTimely diagnosing a uterine rupture is challenging. Based on the pathophysiology of complete uterine wall separation, changes in uterine activity are expected. The primary objective is to identify tocogram characteristics associated with uterine rupture during trial of labor after cesarean section. The secondary objective is to compare the external tocodynamometer with intrauterine pressure catheters.MethodsMEDLINE, EMBASE, and the Cochrane library were systematically searched for eligible records. Moreover, clinical guidelines were screened. Studies analyzing tocogram characteristics of uterine rupture during trial of labor after cesarean section were appraised and included by two independent reviewers. Due to heterogeneity, a meta-analysis was only feasible for uterine hyperstimulation.ResultsThirteen studies were included. Three tocogram characteristics were associated with uterine rupture. (1) Hyperstimulation was more frequently observed compared with controls during the delivery (38 versus 21 % and 58 versus 53 %), and in the last 2 h prior to birth (19 versus 4 %). Results of meta-analysis: OR 1.68 (95 % CI 0.97–2.89), p = 0.06. (2) Decrease of uterine activity was observed in 14–40 % and (3) an increasing baseline in 10–20 %. Five studies documented no changes in uterine activity or Montevideo units. A direct comparison between external tocodynamometer and intrauterine pressure catheters was not feasible.ConclusionsUterine rupture can be preceded or accompanied by several types of changes in uterine contractility, including hyperstimulation, reduced number of contractions, and increased or reduced baseline of the uterine tonus. While no typical pattern has been repeatedly reported, close follow-up of uterine contractility is advised and hyperstimulation should be prevented.

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Section: Resultsmentioning

confidence: 99%

Tocogram characteristics of uterine rupture: a systematic review

Vlemminx

Lau

Oei

2016

Arch Gynecol Obstet

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“…However Beckley et al 15 found that in spite of use of IUPC, uterine ruptures can occur at low pressure due to increased compliance from the previous cesarean scar. In our patient, the uterine contraction and fetal heart rate were monitored by CTG, there was no excessive uterine contraction and fetal bradycardia was the alarming sign for possible UR, so urgent laparotomy was performed that saved the baby.…”

Section: Proceedings In Obstetrics and Gynecology 2017;7(3):6mentioning

confidence: 99%

A rare case of posterior uterine rupture with neonatal survival during trial of vaginal birth after cesarean section

Abbas

Michael

Nagy

2017

Proc Obstet Gynecol

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“…Limitando a discussão à análise do antecedente de cesariana como fator de risco para uma nova cesariana, aquele foi reconhecido como tal [16][17][18] , havendo no entanto quem discorde 13 . No presente estudo o antecedente de cesariana foi observado como fator de risco para cesariana, na razão direta do número de cesarianas prévias.…”

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OR = 4,576;OR=2,346; apresentação pélvica,OR = 4,174; gemelaridade OR = 14,065; hemorragia da segunda metade da prenhez, OR = 28,189;OR = 2,180;OR = 16,738; hipertensão arterial crônica,OR = 4,927, e

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