Vaginal birth after cesarean section: risk of uterine rupture with labor induction

Am J Perinatol. 2011 Sep;28(8):593-6. doi: 10.1055/s-0031-1275386. Epub 2011 Mar 18.

Abstract

We assessed the rate of uterine rupture in patients undergoing labor induction for attempted vaginal birth after cesarean (VBAC). A retrospective study was performed of data from a computerized database. Deliveries from January 1, 1998, to June 30, 2001, in the Southern California Kaiser Permanente system were reviewed and various perinatal characteristics analyzed. A total of 16,218 patients had a prior low transverse cesarean section. Of these, 6832 (42.1%) had a trial of labor. Successful VBAC occurred in 86% of patients with spontaneous onset of labor and 66% of patients with labor induction ( p < 0.001). The uterine rupture rate was not different between patients with spontaneous or induced labor (1.0% versus 1.2%, p = 0.51). Similarly, there was no significant difference between oxytocin or prostaglandin E2 induction (1.4% versus 1.0%, p = 0.59). In our study, labor induction did not appear to increase the risk of uterine rupture in women attempting VBAC.

MeSH terms

  • Adult
  • Dinoprostone / adverse effects
  • Female
  • Humans
  • Labor, Induced / adverse effects*
  • Oxytocics / adverse effects
  • Oxytocin / adverse effects
  • Pregnancy
  • Retrospective Studies
  • Trial of Labor*
  • Uterine Rupture / epidemiology
  • Uterine Rupture / etiology*
  • Vaginal Birth after Cesarean / adverse effects*
  • Young Adult

Substances

  • Oxytocics
  • Oxytocin
  • Dinoprostone