Operative technique at caesarean delivery and risk of complete uterine rupture in a subsequent trial of labour at term. A registry case-control study

Autor: Lone Krebs, Lone Hvidman, Dorthe L. A. Thisted, Laust Hvas Mortensen
Rok vydání: 2017
Předmět:
Physiology
Maternal Health
Peptide Hormones
lcsh:Medicine
Oxytocin
Biochemistry
Prolonged labour
Cervix
Epidural Block
DOUBLE-LAYER CLOSURE
SECTION
Labor and Delivery
0302 clinical medicine
Anesthesiology
Pregnancy
Risk Factors
Medicine and Health Sciences
Birth Weight
Medicine
Anesthesia
Registries
030212 general & internal medicine
lcsh:Science
education.field_of_study
030219 obstetrics & reproductive medicine
Multidisciplinary
Pharmaceutics
Vaginal delivery
Trial of labour
Obstetrics and Gynecology
Neurochemistry
Lipids
Uterine rupture
medicine.anatomical_structure
Physiological Parameters
Female
Neurochemicals
Anatomy
Genital Anatomy
Research Article
Biotechnology
Adult
medicine.medical_specialty
Catheters
INCISION
Birth weight
Population
SINGLE-LAYER
03 medical and health sciences
Drug Therapy
Uterine Rupture
Humans
VAGINAL BIRTH
education
Gynecology
Cesarean Section
business.industry
lcsh:R
Body Weight
Reproductive System
Biology and Life Sciences
medicine.disease
Hormones
Trial of Labor
Case-Control Studies
Birth
Prostaglandins
Women's Health
lcsh:Q
Medical Devices and Equipment
Local and Regional Anesthesia
business
Neuroscience
Zdroj: PLoS ONE
PLoS ONE, Vol 12, Iss 11, p e0187850 (2017)
Thisted, D L A, Mortensen, L H, Hvidman, L & Krebs, L 2017, ' Operative technique at caesarean delivery and risk of complete uterine rupture in a subsequent trial of labour at term. A registry case-control study ', PLOS ONE, vol. 12, no. 11, e0187850, pp. 1-13 . https://doi.org/10.1371/journal.pone.0187850
Thisted, D L A, Mortensen, L H, Hvidman, L & Krebs, L 2017, ' Operative technique at caesarean delivery and risk of complete uterine rupture in a subsequent trial of labour at term. A registry case-control study ', P L o S One, vol. 12, no. 11, 0187850 . https://doi.org/10.1371/journal.pone.0187850
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0187850
Popis: ObjectiveTo estimate the relation of single-layer closure at previous caesarean delivery, and other pre-labour and intra-partum risk factors for complete uterine rupture in trial of vaginal birth after a caesarean (TOLAC) at term.Study designPopulation-based case-control study. We identified all women (n = 39 742) recorded in the Danish Medical Birth Registry (DMBR) during a 12-year period (1997 - 2008) with a singleton pregnancy at term and TOLAC. Among these, all women with a complete uterine rupture were identified (cases). Information from the registry was validated against medical records. Controls were selected in the DMBR as the following two births with TOLAC at term and no uterine rupture. Detailed information from cases and controls was collected from manual review of medical records. Main outcome measure was complete uterine rupture during TOLAC at term.ResultsUpon validation, 175 cases and 272 controls met the above criteria. After adjustment for possible confounding factors there was no association between single layer closure and uterine rupture (aOR 1.38, CI: 0.88 - 2.17). Significant risk factors were: Induction with an unfavourable cervix (aOR 2.10 CI: 1.19 - 3.71), epidural (aOR 2.17 CI 1.31 - 3.57), augmentation by oxytocin for more than one hour (aOR 2.03 CI: 1.20 - 3.44), and birth weight >= 4000g (aOR 2.65 CI 1.05 - 6.64). Previous vaginal delivery (aOR 0.41 CI: 0.25 - 0.68) and inter-delivery interval of more than 24 months (aOR 0.38 CI: 0.18 - 0.78) reduced the risk of uterine rupture.ConclusionSingle-layer uterine closure did not remain significantly associated to uterine rupture during TOLAC at term after adjustment for confounding factors. Induction of labour with an unfavourable cervix, birth weight >= 4000g and indicators of prolonged labour were all major risk factors for uterine rupture.
Databáze: OpenAIRE
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