Perinatal outcomes following uterine rupture during a trial of labor after cesarean: A 12‐year single‐center experience

Author:

Amikam Uri12ORCID,Hochberg Alyssa23ORCID,Segal Roy12,Abramov Shani12,Lavie Anat12,Yogev Yariv12,Hiersch Liran12

Affiliation:

1. Lis Hospital for Women, Sourasky Medical Center Tel Aviv Israel

2. Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel

3. Helen Schneider Hospital for Women, Rabin Medical Center Petach Tikva Israel

Abstract

AbstractObjectiveTo determine perinatal outcomes following uterine rupture during a trial of labor after one previous cesarean delivery (CD) at term.MethodsA retrospective single‐center study examining perinatal outcomes in women with term singleton pregnancies with one prior CD, who underwent a trial of labor after cesarean (TOLAC) and were diagnosed with uterine rupture, between 2011 and 2022. The primary outcome was a composite maternal outcome, and the secondary outcome was a composite neonatal outcome. Additionally, we compared perinatal outcomes between patients receiving oxytocin during labor with those who did not.ResultsOverall, 6873 women attempted a TOLAC, and 116 were diagnosed with uterine rupture. Among them, 63 (54.3%) met the inclusion criteria, and 18 (28%) had the maternal composite outcome, with no cases of maternal death. Sixteen cases (25.4%) had the composite neonatal outcome, with one case (1.6%) of perinatal death. No differences were noted between women receiving oxytocin and those not receiving oxytocin in the rates of maternal composite (35.7% vs 26.5%, P = 0.502, respectively) or neonatal composite outcomes (21.4% vs 26.5%, P = 0.699).ConclusionUterine rupture during a TOLAC entails increased risk for myriad adverse outcomes for the mother and neonate, though possibly more favorable than previously described. Oxytocin use does not affect these risks.

Publisher

Wiley

Subject

Obstetrics and Gynecology,General Medicine

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