Unscarred uterine rupture and subsequent pregnancy outcome — a tertiary centre experience

• Published in: Ginekologia polska 2020-01, Vol.91 (2), p.95-90
• Main Authors: Peker, Nurullah, Aydın, Edip, Evsen, Mehmet Sıddık, Hançer, Fatma Nur, Bademkıran, Muhammet Hanifi, Ege, Serhat, Kahveci, Bekir, Karaçor, Talip, Gül, Talip
• Format: Article
• Language: English
• Subjects: Abdomen; Age; Birth weight; Cesarean section; Drug dosages; Fertility; Gynecology; Health sciences; Hemodynamics; Hospitals; Hysterectomy; Medicine; Morbidity; Mortality; Obstetrics; Pregnancy; Standard deviation; Surgery; Uterus; Womens health
• ISSN: 0017-0011; 2543-6767
• DOI: 10.5603/GP.a2020.0012

OBJECTIVES: The aim of this study was to investigate the incidence, etiology and obstetric outcomes of rupture in unscarreduterine rupture and in those with a history of uterine rupture MATERIAL AND METHODS: The hospital records of women who had delivered between May 2005 and May 2017 at a tertiarycenter were examined retrospectively. Data on patients with unscarred uterine rupture in pregnancy who had undergonefertility-preserving surgery were evaluated. RESULTS: During the study period, 185,609 deliveries occurred. Of those, unscarred uterine rupture has occurred in67 women. There were no ruptures reported in nulliparous women. The rupture was observed in the isthmic region in60 (89.6%) patients and in the fundus in 7 (10.4%) patients. Thirty-eight (56.7%) patients had undergone a total or subtotalhysterectomy, and 29 (43.3%) patients had received primary repair. Ten patients had reconceived after the repair. Of these,eight patients who had a history of isthmic rupture, successfully delivered by elective C-section at 36–37 wk. of gestation,and two experienced recurrent rupture at 33 and 34 wk. of gestation, respectively. Both patients had a history of fundalrupture, and their inter-pregnancy interval was 9 and 11 mo., respectively. CONCLUSIONS: The incidence of rupture in unscarred pregnant uteri was found to be one per 2,770 deliveries. Owing to thehigh morbidity, regarding more than half of the cases with rupture eventuated in hysterectomy, clinicians should be prudentin induction of labour for multiparous women since it was the main cause of rupture in this series. Short inter-pregnancyintervals and history of fundal rupture may confer a risk for rupture recurrence. Those risk factors for recurrence should bevalidated in another studies.