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J Matern Fetal Neonatal Med. 2005 Nov;18(5):339-42.

Previous preterm cesarean delivery: identification of a new risk factor for uterine rupture in VBAC candidates.

Author information

  • 1Department of Obstetrics and Gynecology, North Shore University Hospital, Manhasset, NY 11030, USA. brochels@nshs.edu

Abstract

OBJECTIVE:

A major risk of trials of labor in patients with prior cesarean delivery is uterine rupture. We evaluated the question of whether a previous cesarean delivery at an early gestational age predisposes the patient to subsequent uterine rupture.

METHODS:

This was a retrospective chart review of patients delivering at North Shore University Hospital with a trial of labor after previous cesarean delivery to ascertain all cases of uterine rupture. Patients who had had a previous cesarean delivery at our institution who did not suffer uterine rupture during a trial of labor served as controls.

RESULTS:

Twenty-five patients suffered a uterine rupture. The incidence of prior preterm cesarean delivery (PPCD) in this group was 40%, compared to 10.9% of 691 laboring vaginal birth after cesarean (VBAC) patients without rupture (p < 0.001). Patients in the rupture group with a PPCD were less likely to have experienced labor in the index pregnancy and more likely to have had an interdelivery interval of less than two years.

CONCLUSIONS:

An undeveloped lower segment in the preterm uterus represents a risk for later rupture, even if the incision is transverse.

PMID:
16390795
[PubMed - indexed for MEDLINE]
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