Uterine rupture and dehiscence: ten-year review and case-control study.

Abstract

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: Sumac D Diaz, Jacob E Jones, Michael Seryakov, William J Mann
• Journal: Southern medical journal (South Med J) Vol. 95 Issue 4 Pg. 431-5 (Apr 2002) ISSN: 0038-4348 [Print] United States
• PMID: 11958242 (Publication Type: Journal Article)

Chemical References

• Oxytocin

Topics

• Adolescent
• Adult
• Apgar Score
• Case-Control Studies
• Cesarean Section (adverse effects)
• Female
• Fetal Macrosomia (complications)
• Fetal Monitoring
• Fetal Weight
• Humans
• Infant, Newborn
• Oxytocin (adverse effects)
• Pregnancy
• Pregnancy Outcome
• Risk Factors
• Surgical Wound Dehiscence (etiology, prevention & control)
• Time Factors
• Uterine Rupture (etiology, prevention & control)