Pregnancy after uterine rupture: lower complication risk with delivery before labor onset

  • Fox NS
  • Obstet Gynecol
  • 05.12.2019

  • von Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • Patients pregnant after prior uterine rupture should be delivered by cesarean delivery (CD) prior to the onset of labor.

Why this matters

  • Uterine rupture is associated with maternal and neonatal morbidity and mortality.
  • The rate of recurrence is 0%-33%.

Key results

  • No maternal or neonatal deaths in this cohort.
  • The uterine rupture rate was 0.7%, and the rate of uterine dehiscence was 11.9%.
  • 1 incidental uterine rupture was noted at the time of delivery.

Study design

  • Research letter providing an update to a prior chart review.
  • Subsequent pregnancies >24 weeks with a history of uterine dehiscence (n=75) or rupture (n=59) between 2005 and 2019 were identified.
  • Morbidity related to history of uterine dehiscence or rupture was abstracted from an electronic medical record.
  • Women were delivered by planned CD between 36 weeks and 39 weeks, prior to the onset of labor.
  • Funding: None disclosed.

Limitations

  • This is a rare occurrence, and numbers in the study are small.