Uterine rupture after induction of labour in women with previous caesarean section
- 19 February 2005
- journal article
- Published by Wiley in BJOG: An International Journal of Obstetrics and Gynaecology
- Vol. 112 (4), 451-455
- https://doi.org/10.1111/j.1471-0528.2004.00336.x
Abstract
The issues related to safety of induction of labour in women with previous caesarean section remain controversial. The main adverse outcome fuelling this debate is a "small" risk of uterine rupture that is potentially devastating for both the mother and the fetus. To estimate the risk of uterine rupture or dehiscence in women who require induction of labour with previous caesarean sections. Five year retrospective review of computerised hospital records and case note review of index cases. Large inner city teaching hospital. Two hundred and five women who had their labour induced with history of one lower segment caesarean section. This study was conducted at Liverpool Women's Hospital, a tertiary referral centre, with approximately 6000 births per annum. We searched the hospital's computerised records of deliveries from June 1997 to June 2002 and reviewed all indications and outcomes of induction of labour in women with one previous caesarean section. Women with singleton pregnancy and cephalic presentation were then divided into three groups: those with one previous caesarean section and no previous vaginal deliveries, those whose last delivery was a caesarean section but had delivered vaginally before and those whose last delivery was by vaginal route, but had had one caesarean section in the past. Uterine rupture or dehiscence, adverse neonatal outcome. Two hundred and five women were included. There were four cases of uterine rupture and one dehiscence (2.4%, 95% CI 0.8-5.6%). Two babies were profoundly acidotic at birth, but all five neonates were healthy when discharged from hospital with no long term morbidity. All five cases occurred in the group of women with no previous vaginal deliveries. The intrauterine pressure catheter recordings had contributed to the diagnosis of uterine rupture/dehiscence in three out of five cases. In women with previous caesarean section and no vaginal deliveries, induction of labour carries a relatively high risk of uterine rupture/dehiscence despite all precautions, including intrauterine pressure monitoring.Keywords
This publication has 22 references indexed in Scilit:
- Spontaneous versus induced labor after a previous cesarean deliveryPublished by Ovid Technologies (Wolters Kluwer Health) ,2003
- Induction of Labour After 1 Previous Caesarean SectionAustralian and New Zealand Journal of Obstetrics and Gynaecology, 1999
- Prostaglandin E2for Cervical Ripening: A Multicenter Study of Patients with Prior Cesarean DeliveryAmerican Journal of Perinatology, 1997
- Preinduction Prostaglandin E2 Gel prior to Induction of Labor in Women with a Previous Cesarean SectionGynecologic and Obstetric Investigation, 1995
- Use of Cervical Prostaglandin E2Gel in Patients with Previous Cesarean SectionAmerican Journal of Perinatology, 1994
- A prospective random allocation trial to compare vaginal prostaglandin E2with intravenous oxytocin for labour induction in women previously delivered by caesarean sectionJournal of Obstetrics and Gynaecology, 1993
- Preinductive cervical ripening with prostaglandin E, in women with one previous cesarean sectionActa Obstetricia et Gynecologica Scandinavica, 1992
- Prostaglandin E2Gel Induction of Patients with a Prior Low Transverse Cesarean SectionAmerican Journal of Perinatology, 1992
- The Use Of Pge2 For Induction Of Labor In Parturients With A Previous Cesarean Section ScarActa Obstetricia et Gynecologica Scandinavica, 1989
- Vaginal prostaglandins and labour induction for patients previously delivered by caesarean sectionBJOG: An International Journal of Obstetrics and Gynaecology, 1984