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Latest & greatest articles for Uterine Rupture
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Influence of Caesarean section-pregnancy interval on uterinerupture risk and IVF pregnancy rates: systematic review and mathematical modelling. What is the influence of the Caesarean section-pregnancy interval (CSPI) on the risk of uterinerupture, and what are the repercussions on IVF pregnancy rates of prolonging it?Systematic searches were performed using PubMed MEDLINE to identify studies published up until July 2017 for articles with the following keywords: 'interdelivery interval (...) ' and 'uterinerupture'; 'interpregnancy interval' and 'uterinerupture'; 'interpregnancy interval' and 'cesarean section'; and 'uterinerupture' and 'cesarean section'. The search identified 1609 articles, of which six were included (involving 56,419 women). Four reported significantly higher uterinerupture rates in cases of a short CSPI.From the analysis, the uterinerupture rate can be modelled by a formula corresponding to a hyperbolic curve. There is no clear cut-off in uterinerupture in relation
Classical Cesarean: What Are the Maternal and Infant Risks Compared With Low Transverse Cesarean in Preterm Birth, and Subsequent UterineRupture? A Systematic Review and Meta-analysis. Classical cesarean section may be associated with increased short- and long-term risks. The objectives of this study were to review the following systematically: first, the short-term maternal and infant risks with preterm classical compared with low transverse cesarean sections; and second, the risk (...) unit (ICU) admission. For subsequent pregnancies, our primary outcome was the risk of spontaneous or early-labour uterinerupture. The data were synthesized using random effects, and odds ratios (ORs) and 95% confidence intervals (CIs) were generated. There were no significant differences between preterm classical and low transverse cesarean sections in the odds of maternal death (OR 2.38; 95% CI 0.15-38.07) or ICU admission (adjusted OR 2.38; 95% CI 0.42-13.35). A subgroup from 28 to 31 weeks
Uterinerupture in pregnancy after an intervention complicated by uterine perforation: Case report and systematic review of literature. The present study is a descriptive study of characteristics of women who had a uterinerupture during pregnancy with a history of uterine perforation and no previous caesarean section.We present a case report of a woman with a uterinerupture in pregnancy subsequent to a perforation made by uterine sounding and we performed a systematic review including all (...) case-reports of uterineruptures after perforation during dilatation and curettage or due to uterine sounding.14 case-reports were included in this review. 12 out of 14 women presented with abdominal pain prior to the uterinerupture. In eight out of 14 cases an abdominal ultrasound was performed and in five ultrasounds a uterine wall defect was detected, in two other cases free fluid was visible and in one case fetal bradycardia was seen. Neonatal outcome was uneventful in six cases, there where
Sonographic lower uterine segment thickness after prior cesarean section to predict uterinerupture: a systematic review and meta-analysis. Cesarean section rates are increasing with a decrease in the rate of trial of labor after cesarean section. The objective of this study was to systematically review the predictive characteristics of sonographic measurement of lower uterine segment thickness for uterinerupture during labor.The review was carried out in agreement with PRISMA and SEDATE (...) lower uterine segment measurement and uterine dehiscence and uterinerupture was shown in 27 and four studies, respectively. Nineteen studies were included in a meta-analysis with a subgroup analysis by ultrasound methodology. In the subgroup using the ultrasound methodology associated with uterinerupture, the cut-off value is more precise (2.0-3.65 mm) among these 12 studies. There were 18 cases (1.0%) of uterinerupture, 120 (6.6%) of uterine dehiscence and 1674 (92.4%) women with no uterine
Diagnosis and management of a heterotopic pregnancy and ruptured rudimentary uterine horn Heterotopic pregnancies implanted in a rudimentary uterine horn account for 1 in 2-3 million gestations, and confer significant risk of morbidity due to uterinerupture and hemorrhage.A 34-year-old nullipara presented with acute pelvic pain at 17 weeks of gestation with dichorionic-diamniotic twins, one in each horn of an anomalous uterus first diagnosed in pregnancy as bicornuate. Three-dimensional (...) and ruptured rudimentary uterine horn. This case demonstrates the importance of pre-pregnancy diagnosis and management of mullerian anomalies.
The International Network of Obstetric Survey Systems study of uterinerupture: a descriptive multi-country population-based study International comparison of complete uterine rupture.Descriptive multi-country population-based study.International.International Network of Obstetric Survey Systems (INOSS).We merged individual data, collected prospectively in nine population-based studies, of women with complete uterinerupture, defined as complete disruption of the uterine muscle and the uterine (...) serosa, regardless of symptoms and rupture of fetal membranes.Prevalence of complete uterinerupture, regional variation and correlation with rates of caesarean section (CS) and trial of labour after CS (TOLAC). Severe maternal and perinatal morbidity and mortality.We identified 864 complete uterineruptures in 2 625 017 deliveries. Overall prevalence was 3.3 (95% CI 3.1-3.5) per 10 000 deliveries, 22 (95% CI 21-24) in women with and 0.6 (95% CI 0.5-0.7) in women without previous CS. Prevalence
[Risk of uterinerupture in vaginal birth after cesarean: Systematic review]. To assess the risk of uterinerupture (UR) in attempted vaginal birth after cesarean and to identify risk factors.Systematic review by consulting the following databases: PubMed (MEDLINE), Cochrane Library Plus, Embase, Nursing@Ovid, Cuidatge and Dialnet. The search was conducted between January and March 2015. MeSH descriptors used were: vaginal birth after cesarean; uterinerupture; labor induced and labor obstetric
Tocogram characteristics of uterinerupture: a systematic review. Timely diagnosing a uterinerupture is challenging. Based on the pathophysiology of complete uterine wall separation, changes in uterine activity are expected. The primary objective is to identify tocogram characteristics associated with uterinerupture during trial of labor after cesarean section. The secondary objective is to compare the external tocodynamometer with intrauterine pressure catheters.MEDLINE, EMBASE (...) , and the Cochrane library were systematically searched for eligible records. Moreover, clinical guidelines were screened. Studies analyzing tocogram characteristics of uterinerupture during trial of labor after cesarean section were appraised and included by two independent reviewers. Due to heterogeneity, a meta-analysis was only feasible for uterine hyperstimulation.Thirteen studies were included. Three tocogram characteristics were associated with uterinerupture. (1) Hyperstimulation was more frequently
Sonographic diagnosis of spontaneous uterinerupture at the site of cornual wedge resection scar â€“ a case report Introduction: Uterinerupture and uterine dehiscence during pregnancy are known complications of a scarred uterus. Spontaneous uterinerupture at the site of prior cornual wedge resection has been previously reported in the literature, however remains rare. Discussion: We present a case of uterinerupture at 30 weeks gestation. This woman had previous right sided interstitial (...) pregnancy treated with uncomplicated laparoscopic cornual wedge resection at eight weeks gestation. The index pregnancy occurred eight months after surgery. An emergency ultrasound prompted by non-specific abdominal pain and tenderness at 30 weeks gestation enabled diagnosis of uterine dehiscence. At emergency caesarean section four hours later full thickness wall rupture and haemoperitoneum were found. Surgical intervention resulted in a good outcome for both mother and baby. Conclusion: A brief
Sonographic measurement of lower uterine segment thickness to predict uterinerupture during a trial of labor in women with previous Cesarean section: a meta-analysis. To evaluate the accuracy of antenatal sonographic measurement of lower uterine segment (LUS) thickness in the prediction of risk of uterinerupture during a trial of labor (TOL) in women with a previous Cesarean section (CS).PubMed and EMBASE were searched to identify articles published on the subject of sonographic LUS (...) of included studies was good, although comparison was difficult because of heterogeneity. The estimated sROC curves showed that measurement of LUS thickness seems promising in the prediction of occurrence of uterine defects (dehiscence and rupture) in the uterine wall. The pooled sensitivity and specificity of myometrial LUS thickness for cut-offs between 0.6 and 2.0 mm was 0.76 (95% CI, 0.60-0.87) and 0.92 (95% CI, 0.82-0.97); cut-offs between 2.1 and 4.0 mm reached a sensitivity and specificity of 0.94
Risk of uterinerupture in women undergoing trial of labour with a history of both a caesarean section and a vaginal delivery. To determine the risk of uterinerupture for women undergoing trial of labour (TOL) with both a prior caesarean section (CS) and a vaginal delivery.A systematic literature search was performed using keywords for CS and uterinerupture. The results were critically appraised and the data from relevant and valid articles were extracted. Odds ratios were calculated (...) and a pooled estimate was determined using the Mantel-Haenszel method.Five studies were used for final analysis. Three studies showed a significant risk reduction for women with both a previous CS and a prior vaginal delivery (PVD) compared to women with a previous CS only, and two studies showed a trend towards risk reduction. The absolute risk of uterinerupture with a prior vaginal delivery varied from 0.17 to 0.46%. The overall odds ratio for PVD was 0.39 (95% CI 0.29-0.52, P < 0.00001).Women
Single- versus double-layer closure of the hysterotomy incision during cesarean delivery and risk of uterinerupture. To evaluate the best available evidence regarding the association between single-layer closure and uterine rupture.The PubMed, Embase, and Cochrane Central Register of Controlled Trials databases were searched for relevant observational and experimental studies that included women with a previous single, low, transverse cesarean delivery who had attempted a trial of labor (TOL (...) ). The risks of uterinerupture and uterine dehiscence were assessed by pooled odds ratios (OR) calculated with a random effects model.Nine studies including 5810 women were reviewed. Overall, the risk of uterinerupture during TOL after a single-layer closure was not significantly different from that after a double-layer closure (OR 1.71; 95% confidence interval [CI] 0.66-4.44). However, a sensitivity analysis indicated that the risk of uterinerupture was increased after a locked single-layer closure
Uterinerupture in second-trimester misoprostol-induced abortion after cesarean delivery: a systematic review. To determine the risk of uterinerupture when using misoprostol for second-trimester abortion in women with a history of cesarean delivery.MEDLINE, EMBASE, CINAHL, LILACS, and the Cochrane Library were searched systematically for all articles published before September 2008.Sixty-three articles were found using the above data sources. I excluded case reports, narrative reviews (...) or commentaries, studies that excluded women with a history of cesarean delivery, studies with unrelated outcomes, studies not conducted in humans, and studies that were not available in English. The remaining 16 studies that described misoprostol use for second-trimester abortion in women with a history of cesarean delivery were examined.The number of participants with and without cesarean delivery, regimen of medical abortion used, and cases of uterinerupture were reviewed. To estimate the risk of uterine
Uterinerupture in second-trimester misoprostol-induced abortion after cesarean delivery: a systematic review Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Prediction of uterinerupture associated with attempted vaginal birth after cesarean delivery The purpose of this study was to develop a model that predicts individual-specific risk of uterinerupture during an attempted vaginal birth after cesarean delivery.Women with 1 previous low-transverse cesarean delivery who underwent a trial of labor with a term singleton were identified in a concurrently collected database of deliveries that occurred at 19 academic centers during a 4-year period. We (...) analyzed different classification techniques in an effort to develop an accurate prediction model for uterine rupture.Of the 11,855 women who were available for analysis, 83 women (0.7%) had had a uterinerupture. The optimal final prediction model, which was based on a logistic regression, included 2 variables: any previous vaginal delivery (odds ratio, 0.44; 95% CI, 0.27-0.71) and induction of labor (odds ratio, 1.73; 95% CI, 1.11-2.69). This model, with a c-statistic of 0.627, had poor
[Uterinerupture following operative hysteroscopy]. The aim of this study was to attempt to identify factors predictive of uterinerupture following operative hysteroscopy. A MEDLINE and EMBASE search (1980 to April 2006) using the keywords "hysteroscopy", "uterinerupture" and "pregnancy" was performed with no limitations of languages. 18 cases of uterinerupture following operative hysteroscopy were retrieved. Hysteroscopic metroplasty (uterine septa and synechiae) was involved in 16 (89 (...) %) cases. Hysteroscopic resection was performed with monopolar current cutting, rigid scissors and laser in respectively 14 (78%), 3 (16.5%) and 1 (5.5%) cases. Uterine perforation occurred in 10 (55.5%) cases. The interval between hysteroscopy and subsequent pregnancies varied from 1 month to 5 years with an average delay of 16 months. Uterinerupture occurred between 19 and 41 weeks, with no labour in 12 (66.5%) cases. Four fetal and one maternal deaths followed uterinerupture. Hysteroscopic
WHO systematic review of maternal mortality and morbidity: the prevalence of uterinerupture. To determine the prevalence of uterinerupture worldwide.Systematic review of all available data since 1990.Community-based and facility-based reports from urban and rural studies worldwide. Sample Eighty-three reports of uterinerupture rates are included in the systematic review. Most are facility based using cross-sectional study designs.Following a pre-defined protocol an extensive search (...) was conducted of 10 electronic databases as well as other sources. Articles were evaluated according to specified inclusion criteria. Uterinerupture data were collected along with information on the quality of reporting including definitions and identification of cases. Data were entered into a database and tabulated using SAS software.Prevalence of uterinerupture by country, period, study design, setting, participants, facility type and data source.Prevalence figures for uterinerupture were available
Systematic review of the risk of uterinerupture with the use of amnioinfusion after previous cesarean delivery. Amnioinfusion is commonly used for the intrapartum treatment of women with pregnancy complicated by thick meconium or oligohydramnios with deep variable fetal heart rate decelerations. Its benefit in women with previous cesarean deliveries is less known. Theoretically, rapid increases in intrauterine volume would lead to a higher risk of uterine rupture.Searches of the Cochrane
Factors predisposing to perinatal death related to uterinerupture during attempted vaginal birth after caesarean section: retrospective cohort study. To determine the factors associated with an increased risk of perinatal death related to uterinerupture during attempted vaginal birth after caesarean section.Population based retrospective cohort study.Data from the linked Scottish Morbidity Record and Stillbirth and Infant Death Survey of births in Scotland, 1985-98.All women with one previous (...) caesarean delivery who gave birth to a singleton infant at term by a means other than planned repeat caesarean section (n = 35 854).All intrapartum uterinerupture and uterinerupture resulting in perinatal death (that is, death of the fetus or neonate).The overall proportion of vaginal births was 74.2% and of uterinerupture was 0.35%. The risk of intrapartum uterinerupture was higher among women who had not previously given birth vaginally (adjusted odds ratio 2.5, 95% confidence interval 1.6 to 3.9