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uterine rupture

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This occurs once in approximately every 1500 deliveries in the UK. This condition is much more common in parts of Africa where the incidence is approximately 1 in 100 deliveries.

Rupture may occur apparently spontaneously or it may result from trauma before or during labour.

Uterine scars are a risk factor for rupture.

Scar rupture:

  • classical CS causes 2% rupture in subsequent pregnancies
  • LSCS is associated with 0.2% rupture
  • previous myomectomy or hysterotomy are associated with increased rupture rates

Risk factors for rupture, in the absence of uterine scars:

  • multiparity
  • cephalopelvic disproportion
  • syntocinon augmentation of labour

Fetal mortality and maternal mortality:

  • there is an approximate 5% maternal mortality and 30% fetal mortality associated with this condition

Note that a model attempting to identify risk of uterne rupture concluded that:

  • factors that were available before or at admission for delivery cannot be used to predict accurately the relatively small proportion of women at term who will experience a uterine rupture during an attempted vaginal birth after cesarean delivery (1)

Reference:

Last reviewed 01/2018

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