OBJECTIVE: We sought to characterize the labor of women attempting trial of labor after cesarean (TOLAC) who experience uterine rupture. STUDY DESIGN: We conducted a secondary analysis of a nested case-control study of women attempting TOLAC. Women experiencing uterine rupture (cases) were compared to 2 reference groups: successful TOLAC and failed TOLAC. Interval-censored regression was used to estimate the median time to progress 1 cm in dilation and the total time from 4-10 cm. RESULTS: A total of 115 cases were compared to 341 successful TOLAC and 120 failed TOLAC. The time to progress 1 cm was similar between groups until 7-cm dilation. After 7 cm, cases of uterine rupture required longer to progress than successful TOLAC (median [95th percentile] time from 7-8 cm: 0.38 [1.91] vs 0.16 [0.79] hours; from 8-9 cm: 0.28 [1.10] vs 0.10 [0.39] hours). Women with a uterine rupture had labor curves similar to those with a failed TOLAC. CONCLUSION: Women with labor dystocia in the active phase of labor should be closely monitored for uterine rupture in TOLAC.
OBJECTIVE: We sought to characterize the labor of women attempting trial of labor after cesarean (TOLAC) who experience uterine rupture. STUDY DESIGN: We conducted a secondary analysis of a nested case-control study of women attempting TOLAC. Women experiencing uterine rupture (cases) were compared to 2 reference groups: successful TOLAC and failed TOLAC. Interval-censored regression was used to estimate the median time to progress 1 cm in dilation and the total time from 4-10 cm. RESULTS: A total of 115 cases were compared to 341 successful TOLAC and 120 failed TOLAC. The time to progress 1 cm was similar between groups until 7-cm dilation. After 7 cm, cases of uterine rupture required longer to progress than successful TOLAC (median [95th percentile] time from 7-8 cm: 0.38 [1.91] vs 0.16 [0.79] hours; from 8-9 cm: 0.28 [1.10] vs 0.10 [0.39] hours). Women with a uterine rupture had labor curves similar to those with a failed TOLAC. CONCLUSION:Women with labor dystocia in the active phase of labor should be closely monitored for uterine rupture in TOLAC.
Authors: Jun Zhang; Helain J Landy; D Ware Branch; Ronald Burkman; Shoshana Haberman; Kimberly D Gregory; Christos G Hatjis; Mildred M Ramirez; Jennifer L Bailit; Victor H Gonzalez-Quintero; Judith U Hibbard; Matthew K Hoffman; Michelle Kominiarek; Lee A Learman; Paul Van Veldhuisen; James Troendle; Uma M Reddy Journal: Obstet Gynecol Date: 2010-12 Impact factor: 7.661
Authors: Mark B Landon; John C Hauth; Kenneth J Leveno; Catherine Y Spong; Sharon Leindecker; Michael W Varner; Atef H Moawad; Steve N Caritis; Margaret Harper; Ronald J Wapner; Yoram Sorokin; Menachem Miodovnik; Marshall Carpenter; Alan M Peaceman; Mary Jo O'Sullivan; Baha Sibai; Oded Langer; John M Thorp; Susan M Ramin; Brian M Mercer; Steven G Gabbe Journal: N Engl J Med Date: 2004-12-14 Impact factor: 91.245
Authors: George A Macones; Jeffrey Peipert; Deborah B Nelson; Anthony Odibo; Erika J Stevens; David M Stamilio; Emmanuelle Pare; Michal Elovitz; Anthony Sciscione; Mary D Sammel; Sarah J Ratcliffe Journal: Am J Obstet Gynecol Date: 2005-11 Impact factor: 8.661