Risk of uterine rupture following induction of labour in women with a previous caesarean section in a large UK teaching hospital

Background: Uterine rupture remains a major obstetric problem particularly in less developed countries. The aim of this study was to identify determinants of uterine rupture among mothers getting delivery services in Dessie Referral Hospital from January 2016 to June 2016, North East Ethiopia.Methods: A prospective unmatched case control study was conducted recruiting 42 mothers with uterine rupture as case group and 168 for control group. Pretested, structured questionnaire was used to collect data.Results: Descriptive statistics and Logistic regression models were utilized considering 95% confidence interval and p-value of 0.05 to determine the presence and strength of association between dependent and independent variables. Majority (94.2%) of cases came from rural areas, 76.2% had obstructed labor and 55% had prolonged labor. Of 85.7% of cases have reported number of pregnancies ≥ 5. Mothers who encountered obstructed labor and previous Caesarean section scar were at higher risk of uterine rupture (AOR=22.2, 95% CI=2.8-4.1 and AOR=13.6, 95% CI=2.16-17.84 respectively). Mothers living in urban area, having Antenatal Care follow-up, shorter labor stay and primi-parity were found to have lower risk of uterine rupture.Conclusions: This study revealed that living in rural areas, absence of Antenatal Care follow-up, prolonged labor, obstructed labor, grand multiparity and previous Caesarean section scar were determinants of uterine rupture. Viable strategies have to be designed and implemented to tackle these determinants of uterine rupture.

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Discrimination by parity is a prerequisite for assessing induction of labour outcome – cross-sectional study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03334-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Branko Denona ◽

Michael Foley ◽

Rhona Mahony ◽

Michael Robson

Keyword(s):

Caesarean Section ◽

Cross Sectional Study ◽

Induction Of Labour ◽

Previous Caesarean Section ◽

Sectional Study ◽

Cross Sectional ◽

Nulliparous Women ◽

Significant Difference ◽

Multiparous Women ◽

Group 3

Abstract Background To demonstrate that studies on induction of labour should be analyzed by parity as there is a significant difference in the labour outcome among induced nulliparous and multiparous women. Methods Obstetric outcome, specifically caesarean section rates, among induced term nulliparous and multiparous women without a previous caesarean section were analyzed in this cross-sectional study using the Robson 10 group classification for the year 2016. Results In the total number of 8851 women delivered in 2016, the caesarean section rates among nulliparous women in spontaneous and induced labour, Robson groups 1 and 2A, were 7.84% (151/1925) and 32.63% (437/1339) respectively and among multiparous (excluding those women with a previous caesarean section), Robson group 3 and 4A were 1%(24/2389) and 4.37% (44/1005), respectively. Pre labour caesarean rates for nulliparous and multiparous women, Robson groups 2B and 4B (Robson M, Fetal Matern Med Rev, 12; 23–39, 2001) were 3.91% (133/3397) and 2.86% (100/3494), of the respective single cephalic cohort at term. Conclusion The data suggests that studies on induction of labour should be analyzed by parity as there is a significant difference between nulliparous and multiparous women.

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Indications for Caesarean Section and its Fetal and Maternal Outcome in a Teaching Hospital, Province Five, Nepal

Journal of Karnali Academy of Health Sciences ◽

10.3126/jkahs.v3i1.28462 ◽

2020 ◽

Vol 3 (1) ◽

Author(s):

Asha Panth ◽

Saraswoti Kumari Gautam Bhattarai ◽

Sunita Acharya

Keyword(s):

Caesarean Section ◽

Teaching Hospital ◽

Neonatal Intensive Care ◽

Post Partum ◽

Previous History ◽

Structured Interview ◽

Maternal Outcome ◽

Previous Caesarean Section ◽

Obstructed Labor ◽

Cross Sectional

Introduction: Cesarean section (CS) is an operative technique by which a fetus is delivered through an abdominal and uterine incision and is effective in saving maternal and infant lives but caesarean section rates higher than 10% are not associated with reductions in maternal and newborn mortality rates. The objective of the study was to find out the indications for caesarean section and its fetal and maternal outcomes in a Teaching Hospital, Province Five, Nepal. Methods: A descriptive, cross-sectional study was conducted in a teaching hospital, Nepal. A total of 150 purposively selected postnatal mothers after caesarean section were interviewed by face to face technique using a structured interview schedule. Analysis and interpretation of the findings were done with the help of descriptive and inferential statistics. Results: The study shows that the majority (93.3%) of mothers had undergone an emergency caesarean section and the majority (92%) had maternal indications for caesarean section. Among them, one third had a previous caesarean section followed by 14.5% obstructed labor. Fetal indications include breach (44.4%), fetal distress (29.6%), big baby (11.1) and twins and triplets (3.7%). Only (10.7%) had an unfavorable fetal outcome which includes the need for Neonatal Intensive Care Unit (NICU) (31.2%) followed by neonatal death (25%). Only three mothers (2%) had an unfavorable maternal outcome which includes Post-Partum Hemorrhage (PPH); need for blood transfusion and fever respectively. There is no statistically significant association between sociodemographic characteristics and type of caesarean section. There is a statistically significant association between the previous history of caesarean section and type of caesarean section (P= .005). Conclusions: Previous caesarean section was the most common indication for caesarean section. Unfavorable outcome after caesarean section was considerably present which needs to be addressed.

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A CASE REPORT -UTERINE RUPTURE AFTER PREVIOUS CAESAREAN SECTION

EPRA International Journal of Multidisciplinary Research (IJMR) ◽

10.36713/epra6415 ◽

2021 ◽

pp. 184-186

Author(s):

Dr.Amrita Kishor Jeswani ◽

Dr.Suman Saurabh Gupta ◽

Dr.Rohit Kishor Jeswani

Keyword(s):

Caesarean Section ◽

Uterine Rupture ◽

Rare Complication ◽

Signs And Symptoms ◽

Gravid Uterus ◽

Previous Caesarean Section ◽

Risk Of Rupture ◽

Life Threatening ◽

Rupture Of Uterus ◽

Present Case Study

Uterine rupture though a rare complication is life threatening for mother as well as baby. The commonest cause for rupture of a gravid uterus is previous caesarean section. It is important that the risk of rupture of uterus is explained to the pregnant female who has undergone previous caesarean section. The symptoms with which the patient presents can be subjective and vague like pain in abdomen or of acute abdomen. The patient can also come with objective findings like non-reassuring fetal status and loss of fetal station. With previous caesarean section it is important to be vigilant throughout the pregnancy especially in third trimester. It is also imperative that the patient should be educated about the signs and symptoms of rupture uterus so that timely intervention can be done to save the life of mother and the baby. In the present case study, the USG scan revealed that the placenta had shifted and was covering the internal os from fundo-posterior position along with the shift of baby from cephalic presentation to transverse lie. Hence these case was a suspicious of rupture uterus which causes change in lie as well as presentation of baby.

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