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Am J Obstet Gynecol. 2004 May;190(5):1476-8.

Risk of uterine rupture in labor induction of patients with prior cesarean section: an inner city hospital experience.

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1
Department of Gynecology and Obstetrics, Emory University at Grady Healthcare System, Atlanta, GA, USA.

Abstract

OBJECTIVE:

This study was undertaken to determine the risk of uterine rupture in patients induced with oxytocin or misoprostol after 1 or more previous cesarean sections.

STUDY DESIGN:

Patients with 1 or more previous cesarean sections who delivered after 28 weeks' gestation between 1996 and 2002 were identified by database. Among 3533 total patients, rates of uterine rupture were compared among 4 groups: oxytocin induction (n = 430), misoprostol induction (n = 142), spontaneous labor (n = 2523), and repeat cesarean section without labor (n = 438). Statistical analysis included chi(2) test, Fisher exact test, unpaired t test, and Mantel-Haenszel test.

RESULTS:

Rate of rupture was increased in all inductions compared with that of the spontaneous labor group. Among patients with 1 prior cesarean, rupture rates with misoprostol and oxytocin induction were 0.8% and 1.1%, respectively.

CONCLUSION:

Induction of labor with oxytocin or misoprostol is associated with a higher rate of uterine rupture compared with those who deliver after spontaneous labor. After 1 prior cesarean, rupture rate with misoprostol induction is not increased compared with oxytocin induction.

PMID:
15167874
DOI:
10.1016/j.ajog.2004.02.035
[Indexed for MEDLINE]
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