BACKGROUND: Previous cesarean section, oxytocin administration, and fetal macrosomia increase the risk of uterine rupture or dehiscence (URD). METHODS: All 25,718 deliveries at Riverside Regional Medical Center from January 1990 to June 2000 were reviewed to describe complications and identify risk factors for URD. RESULTS: Eleven uterine ruptures and 10 dehiscences occurred during this period (0.08%). One maternal death (5%) and three neonatal deaths (14%) occurred. Other complications included intrapartum nonreassuring fetal status (67%), 5-minute Apgar score < 7 (52%), maternal blood transfusion (24%), neonatal hypoxic injury (14%), hysterectomy (14%), and endometritis (10%). Uterine rupture/dehiscence was independently associated with fetal weight > or = 4,000 g, nonreassuring fetal status, use of oxytocin, and previous cesarean delivery; internal fetal monitoring reduced the risk of URD. CONCLUSIONS: To reduce the risk of URD, a delivery plan should include assessment of cesarean history and fetal macrosomia,judicious use of oxytocin, and intrapartum monitoring for nonreassuring fetal status.
BACKGROUND: Previous cesarean section, oxytocin administration, and fetal macrosomia increase the risk of uterine rupture or dehiscence (URD). METHODS: All 25,718 deliveries at Riverside Regional Medical Center from January 1990 to June 2000 were reviewed to describe complications and identify risk factors for URD. RESULTS: Eleven uterine ruptures and 10 dehiscences occurred during this period (0.08%). One maternal death (5%) and three neonatal deaths (14%) occurred. Other complications included intrapartum nonreassuring fetal status (67%), 5-minute Apgar score < 7 (52%), maternal blood transfusion (24%), neonatal hypoxic injury (14%), hysterectomy (14%), and endometritis (10%). Uterine rupture/dehiscence was independently associated with fetal weight > or = 4,000 g, nonreassuring fetal status, use of oxytocin, and previous cesarean delivery; internal fetal monitoring reduced the risk of URD. CONCLUSIONS: To reduce the risk of URD, a delivery plan should include assessment of cesarean history and fetal macrosomia,judicious use of oxytocin, and intrapartum monitoring for nonreassuring fetal status.
Authors: Kaundinya Kiran Bharatam; P K Sivaraja; N J Abineshwar; Vasundhara Thiagarajan; D A Thiagarajan; Sudeep Bodduluri; K B Sriraman; A Vasantha Ragavan; Shanmuga Priya Journal: Int J Surg Case Rep Date: 2015-02-11
Authors: Chris-Henrik Wulfert; Christian Theodor Müller; Ahmed Farouk Abdel-Kawi; Wolfgang Schulze; Henning Schmidt-Seithe; Sonko Borstelmann; Gunnar Loske Journal: Innov Surg Sci Date: 2020-10-01
Authors: A J M W Vervoort; L B Uittenbogaard; W J K Hehenkamp; H A M Brölmann; B W J Mol; J A F Huirne Journal: Hum Reprod Date: 2015-09-25 Impact factor: 6.918
Authors: J Vissers; T C Sluckin; C C Repelaer van Driel-Delprat; R Schats; C J M Groot; C B Lambalk; J W R Twisk; J A F Huirne Journal: Hum Reprod Date: 2020-03-27 Impact factor: 6.918