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

Objective: To evaluate the relation between peripartum infection at first caesarean delivery to uterine dehiscence or rupture at the subsequent delivery. Design: Retrospective case-control study from March 2014 to October 2020. Setting: University-affiliated medical centre. Sample: Women with a prior caesarean delivery and proven dehiscence or uterine rupture diagnosed during their subsequent delivery. The control group included women who had a successful vaginal birth after Cesarean section without evidence of dehiscence or uterine rupture. Methods: We compared the rate of peripartum infection during the first Cesarean delivery and other relevant variables, between the two groups. We also analysed the type of infection correlated with uterine rupture or dehiscence. Main Outcome Measures: Rate of peripartum infection. Results: A total of 168 women were included, 71 with uterine rupture or dehiscence and 97 with successful vaginal birth after Cesarean section 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 labour after Cesarean delivery (95% CI, P=0.018). We also found that endometritis had the highest correlation to uterine rupture (9.8% vs. 0%, p=0.02) Conclusion: Peripartum infection in the first caesarean delivery, may be an independent risk-factor for uterine rupture in a subsequent delivery. Compared to other infections, endometritis may pose the greatest risk for uterine rupture or dehiscence.

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Can Intrapartum Cardiotocography Predict Uterine Rupture among Women with Prior Caesarean Delivery?: A Population Based Case-Control Study

PLoS ONE ◽

10.1371/journal.pone.0146347 ◽

2016 ◽

Vol 11 (2) ◽

pp. e0146347 ◽

Cited By ~ 5

Author(s):

Malene M. Andersen ◽

Dorthe L. A. Thisted ◽

Isis Amer-Wåhlin ◽

Lone Krebs ◽

Keyword(s):

Uterine Rupture ◽

Caesarean Delivery ◽

Case Control Study ◽

Population Based ◽

Case Control ◽

Control Study

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Adherence to guidelines and suboptimal practice in term breech delivery with perinatal death- a population-based case-control study in Norway

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2464-7 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Solveig Bjellmo ◽

Sissel Hjelle ◽

Lone Krebs ◽

Elisabeth Magnussen ◽

Torstein Vik

Keyword(s):

Caesarean Delivery ◽

Case Control Study ◽

Perinatal Death ◽

Population Based ◽

Case Control ◽

Case Group ◽

National Guidelines ◽

Breech Delivery ◽

Perinatal Audit ◽

Control Study

Abstract Background In a recent population-based study we reported excess risk of neonatal mortality associated with vaginal breech delivery. In this case-control study we examine whether deviations from Norwegian guidelines are more common in breech deliveries resulting in intrapartum or neonatal deaths than in breech deliveries where the offspring survives, and if these deaths are potentially avoidable. Material and methods Case-control study completed as a perinatal audit including term breech deliveries of singleton without congenital anomalies in Norway from 1999 to 2015. Deliveries where the child died intrapartum or in the neonatal period were case deliveries. For each case, two control deliveries who survived were identified. All the included deliveries were reviewed by four obstetricians independently assessing if the deaths in the case group might have been avoided and if the management of the deviations from Norwegian guidelines were more common in case than in control deliveries. Results Thirty-one case and 62 control deliveries were identified by the Medical Birth Registry of Norway. After exclusion of non-eligible deliveries, 22 case and 31 control deliveries were studied. Three case and two control deliveries were unplanned home deliveries, while all in-hospital deliveries were in line with national guidelines. Antenatal care and/or management of in-hospital deliveries was assessed as suboptimal in seven (37%) case and two (7%) control deliveries (p = 0.020). Three case deliveries were completed as planned caesarean delivery and 12 (75%) of the remaining 16 deaths were considered potentially avoidable had planned caesarean delivery been done. In seven of these 16 deliveries, death was associated with cord prolapse or difficult delivery of the head. Conclusion All in-hospital breech deliveries were in line with Norwegian guidelines. Seven of twelve potentially avoidable deaths were associated with birth complications related to breech presentation. However, suboptimal care was more common in case than control deliveries. Further improvement of intrapartum care may be obtained through continuous rigorous training and feedback from repeated perinatal audits.

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Determinants of uterine rupture among cases of Adama city public and private hospitals, Oromia, Ethiopia: a case control study

Reproductive Health ◽

10.1186/s12978-018-0606-4 ◽

2018 ◽

Vol 15 (1) ◽

Cited By ~ 5

Author(s):

Fikru Abebe ◽

Ephrem Mannekulih ◽

Abebe Megerso ◽

Abdurahman Idris ◽

Tsegaye Legese

Keyword(s):

Uterine Rupture ◽

Case Control Study ◽

Case Control ◽

Private Hospitals ◽

Public And Private ◽

Public And Private Hospitals ◽

Control Study

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An enhanced recovery programme after caesarean delivery increases maternal satisfaction and improves maternal-neonatal bonding: A case control study

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/j.ejogrb.2016.12.034 ◽

2017 ◽

Vol 210 ◽

pp. 212-216 ◽

Cited By ~ 12

Author(s):

Anne Laronche ◽

Luiza Popescu ◽

Dan Benhamou

Keyword(s):

Caesarean Delivery ◽

Case Control Study ◽

Enhanced Recovery ◽

Case Control ◽

Maternal Satisfaction ◽

Enhanced Recovery Programme ◽

Control Study

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Associated Factors and Outcome of Uterine Rupture at Suhul General Hospital, Shire Town, North West Tigray, Ethiopia 2016: A Case-Control Study

Obstetrics and Gynecology International ◽

10.1155/2017/8272786 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Tefera Marie Bereka ◽

Amlaku Mulat Aweke ◽

Tewodrose Eshetie Wondie

Keyword(s):

General Hospital ◽

Uterine Rupture ◽

Associated Factors ◽

Case Control Study ◽

Perinatal Death ◽

Case Control ◽

Uterine Wall ◽

Obstructed Labor ◽

North West ◽

Control Study

Background. Uterine rupture is tearing of the uterine wall during pregnancy or delivery. It may extend to partial or whole thickness of the uterine wall. It is usually a case where obstetric care is poor. In extensive damage, death of the baby and sometimes even maternal death are evident.Objective. This study assesses associated factors and outcome of uterine rupture at Suhul General Hospital, Tigray Region, Ethiopia, 2016.Methodology. A case-control study was conducted by review of data from September 2012 to August 2016. A total of 336 samples were studied after calculating by EPI-INFO using proportion of multiparity (53%) and ratio of 1 : 2 for cases and controls, respectively. Analysis was done using SPSS version 20. Bivariate and multivariate logistic regression was applied withp<0.05.Result. ANC, grand multiparity, malpresentation, and obstructed labor had association, but previous cesarean delivery was not significant. Perinatal mortality was 105 (93%) versus 13 (5.8%) in cases and controls, respectively. Anemia was highest for both groups (53.7% versus 32.1%).Conclusion. Majority of uterine rupture is attributed to prolonged or obstructed labor. Cases of uterine rupture had prompt management preventing maternal mortality, but burden of perinatal death is still high.

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