Risk of uterine rupture in multiparous women after induction of labor with prostaglandin: A national population-based cohort study.

Abstract

OBJECTIVE:

To assess whether, after induction of labor with prostaglandin, multiparous (≥2 para) women have an increased risk of uterine rupture compared with nulliparous or uniparous women.

METHODS:

This was a retrospective population-based cohort study including women who underwent induction with prostaglandin in all maternity wards in Sweden between May 1996 and December 2019 (n = 56 784). The study cohort was obtained by using data from the Swedish Medical Birth Register, which contains information from maternity and delivery records. The main outcome measure was uterine rupture.

RESULTS:

Overall, multiparous women induced with prostaglandin had an increased risk of uterine rupture compared with nulliparous women (adjusted odds ratio [OR], 3.33 [95% confidence interval (CI), 1.38-8.04]; P < 0.007). Multiparous women with no previous cesarean section (CS) induced with prostaglandin had more than three times higher risk of uterine rupture (crude OR, 3.55 [95% Cl, 1.48-8.53]; P = 0.005) compared with nulliparous women and four times higher risk compared with uniparous women (OR, 4.10 [95% CI, 1.12-15.00]; P < 0.033). Multiparous women with previous CS had a decreased risk of uterine rupture compared with uniparous women with one previous CS (crude OR, 0.41 [95% Cl, 0.21-0.78]; P = 0.007).

CONCLUSION:

Our study implies that multiparity in women with no previous CS is a risk factor for uterine rupture when induced with prostaglandin. This should be taken into consideration when deciding on the appropriate method of induction.

• Authors: Johanna Ryberg, Ylva Carlsson, Martin Svensson, Erik Thunström, Teresia Svanvik
• Journal: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (Int J Gynaecol Obstet) Vol. 165 Issue 1 Pg. 328-334 (Apr 2024) ISSN: 1879-3479 [Electronic] United States
• PMID: 37925605 (Publication Type: Journal Article)
• Copyright: © 2023 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

Chemical References

• Prostaglandins

Topics

• Pregnancy
• Female
• Humans
• Parity
• Uterine Rupture (epidemiology, etiology)
• Cesarean Section (adverse effects)
• Prostaglandins
• Retrospective Studies
• Cohort Studies
• Labor, Induced (adverse effects, methods)
• Vaginal Birth after Cesarean