Cesarean Delivery Complicated by Peripartum Infection and Risk of Uterine Rupture During Subsequent Trial of Labor.

Autor: Tamir Yaniv R; Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel., Farladansky-Gershnabel S; Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel., Gluska H; Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel., Daykan Y; Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel., Shechter Maor G; Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel., Schonman R; Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel., Biron-Shental T; Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel.
Jazyk: angličtina
Zdroj: Journal of women's health (2002) [J Womens Health (Larchmt)] 2024 Jul; Vol. 33 (7), pp. 986-990. Date of Electronic Publication: 2024 Mar 19.
DOI: 10.1089/jwh.2023.0727
Abstrakt: Background: Uterine rupture is a rare, but dangerous obstetric complication that can occur during trial of vaginal birth. Methods: The aim of this study was to evaluate the relationship between peripartum infection at the first caesarean delivery to uterine dehiscence or rupture at the subsequent delivery. We conducted a retrospective case-control study from March 2014 to October 2020 at a single academic medical center. The study group included women with a prior caesarean delivery and proven dehiscence or uterine rupture diagnosed during their subsequent delivery. The control group included women who went through a successful vaginal birth after cesarean section (VBAC) without evidence of dehiscence or uterine rupture. We compared the rate of peripartum infection during the first cesarean delivery (CD) and other relevant variables, between the two groups. Results: A total of 168 women were included, 71 with uterine rupture or dehiscence and 97 with successful VBAC as the control group. The rate of peripartum infection at the first caesarean delivery was significantly higher in the study group compared to the control group (22.2% vs. 8.2%, p  = 0.013). Multivariate logistic regression analysis found that peripartum infection remained an independent risk factor for uterine rupture at the subsequent trial of labor after CD (95% confidence interval, p  = 0.034). Conclusion: Peripartum infection in the first caesarean delivery, may be an independent risk-factor for uterine rupture in a subsequent delivery.
Databáze: MEDLINE