Can a VBAC scoring system predict uterine rupture in patients attempting a trial of labor?

1999 ◽  
Vol 93 (4) ◽  
pp. S64 ◽  
Author(s):  
V ALAMIAJR ◽  
B MEYER ◽  
O SELIOUTSKI ◽  
N VOHRA
2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
Meleesa Joy Schultz ◽  
Triveni Nanda

The risk of uterine rupture during attempted trial of labor after caesarean delivery (TOLAC) is well documented. However, vaginal rupture (in the absence of obstructed labour) is exceptionally uncommon. Below is described the rare case of a 37-year-old multiparous woman attempting TOLAC, who suffered a vaginal—rather than uterine—rupture, during the first stage of spontaneous labour. This case is an important reminder to obstetricians that concealed ruptures of both the vagina and uterus do occur and must be considered in clinical situations where another explanation is not apparent.


Author(s):  
Pratibha Devabhaktuni ◽  
Padmaja Allani ◽  
Maheen F.

Background: Between January 2001 to September 2003, 46,171 deliveries were recorded, the number of caesarean deliveries during this period of two years and nine months were 16,182 (35.04%).  Methods: An Audit from the Institute of obstetrics and gynecology, of uterine ruptures.Results: Total 81 cases of uterine rupture were managed at the Institute. Total number of scar ruptures managed were, 48/81 uterine ruptures. Five women had previous classical upper segment caesarean, and in previous lower segment caesarean section (LSCS), there were 43 cases of rupture uterus. In two cases following forceps delivery, traumatic uterine ruptures were recorded. Spontaneous ruptures were 31 during the study period. Bladder rupture occurred in 13 cases, 16.04% of uterine ruptures.  The fetal outcome in uterine ruptures 81 cases, live births were 19-23.45%. The number of vaginal births after caesarean section were 261, 215, 186 in the years 2001, 2002 and 2003 at the Institute of obstetrics and gynecology. The number of scar ruptures were 7/261, 9/215, 2/186 in the respective years. Hysterectomy was done in 43/81=53.08%. Rent repair of the uterine rupture was done in 38/81.Conclusions: An Audit from the Institute of obstetrics and gynecology, of uterine ruptures has provided the following data that gives an insight into the practice of obstetrics during the decade 2000 to 2010 in the teaching Institute.  Caesarean deliveries accounted for 35.04% of the total deliveries.  Repeat caesarean sections were 7105, 43.9%. The number of vaginal births after caesarean section (VBAC) were 662. Scar ruptures in VBAC were 18 /662-2.71%. The maternal mortality in MGMH study was 3/81 uterine ruptures-3.7%. Scar ruptures constituted, 48/81-59.25% of uterine ruptures. Trial of labor after caesarean (TOLAC) and VBAC are practiced in the teaching Institute.


2016 ◽  
Vol 214 (1) ◽  
pp. S419
Author(s):  
Lindsay Maggio ◽  
Rosemary J. Froehlich ◽  
Joshua D. Dahlke ◽  
Phinnara Has ◽  
Dwight J. Rouse ◽  
...  

2018 ◽  
Vol 298 (2) ◽  
pp. 273-277 ◽  
Author(s):  
Lina Salman ◽  
Liran Hiersch ◽  
Anat Shmueli ◽  
Eyal Krispin ◽  
Arnon Wiznitzer ◽  
...  

1999 ◽  
Vol 181 (4) ◽  
pp. 872-876 ◽  
Author(s):  
Aaron B. Caughey ◽  
Thomas D. Shipp ◽  
John T. Repke ◽  
Carolyn M. Zelop ◽  
Amy Cohen ◽  
...  

2020 ◽  
Author(s):  
Huan ZHANG ◽  
Haiyan LIU ◽  
Shouling LUO ◽  
Weirong Gu

Abstract Background Trial of labor after a previous cesarean delivery (TOLAC) has helped to reduce the rate of cesarean section (CS). But the increased rate of adverse outcomes limites the spread of TOLAC. The most serious one is the risk of symptomatic uterine rupture, which is possibly associated with oxytocin. This meta-analysis was to evaluate the risk association between oxytocin use and uterine rupture in TOLAC. Methods Multiple electronic databases (PubMed, Embase, Web of Science, and Google Scholar) were searched for case-control or cross-sectional studies about TOLAC, oxytocin and uterine rupture, which were published between January 1986 and October 2019. The bias-corrected Hedge's g was calculated as the effect size using the random-effects model. The risk of bias was evaluated by the Newcastle-Ottawa Scale (NOS). Quality of the evidence was assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) certainty ratings system. Results There were 14 studies meeting inclusion criteria including 48457 women undergoing TOLAC. The pooled rate of VBAC and rate of uterine rupture in spontaneous labor were 74.3% and 0.7%. And the pooled rate of VBAC and rate of uterine rupture in induction labor were 60.7% and 2.2%. The women with spontaneous labor had significantly higher rate of VBAC (p=0.0032) and lower rate of uterine rupture (p=0.0003) than that with induction labor. The pooled rates of uterine rupture in women using oxytocin and women not using oxytocin in TOLAC were 1.4% and 0.5%. There was significant difference between these two groups (p=0.0002). Conclusions In TOLAC, women with induction labor had higher risk of uterine rupture than that with spontaneous labor. Oxytocin use may increase the risk. So simplified and standardized intrapartum management, precise procotol and cautiously monitoring of oxytocin in TOLAC are necessary.


NeoReviews ◽  
2017 ◽  
Vol 18 (12) ◽  
pp. e721-e728
Author(s):  
Emma Clear ◽  
Mara J. Dinsmoor

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