Risk factors and outcomes associated with type of uterine rupture

• Published in: Archives of gynecology and obstetrics 2022-12, Vol.306 (6), p.1967-1977
• Main Authors: Dimitrova, D., Kästner, AL, Kästner, AN, Paping, A., Henrich, W., Braun, T.
• Format: Article
• Language: English
• Subjects: Cesarean section; Cesarean Section, Repeat - adverse effects; Endocrinology; Female; Gynecology; Human Genetics; Humans; Maternal-Fetal Medicine; Medicine; Medicine & Public Health; Obstetrics/Perinatology/Midwifery; Pregnancy; Retrospective Studies; Risk Factors; Trial of Labor; Uterine Rupture - epidemiology; Uterine Rupture - etiology; Vagina; Vaginal Birth after Cesarean - adverse effects
• ISSN: 1432-0711; 0932-0067; 1432-0711
• DOI: 10.1007/s00404-022-06452-0

Purpose To identify risk factors associated with the occurrence of complete uterine rupture (CUR) in comparison to partial uterine rupture (PUR) to further investigate to what extent a standardized definition is needed and what clinical implications can be drawn. Methods Between 2005 and 2017 cases with CUR and PUR at Charité University Berlin, Germany were retrospectively identified. Demographic, obstetric and outcome variables were analyzed regarding the type of rupture. Binary multivariate regression analysis was conducted to identify risk factors associated with CUR. In addition, the intended route of delivery (trial of labor after cesarean delivery (TOLAC) and elective repeat cesarean delivery (ERCD)), divided according to the type of rupture, was compared. Results 92 cases with uterine rupture were identified out of a total of 64.063 births (0.14%). Puerperal complications were more frequent in CUR (67.9 versus 41.1%, p  = 0.021). Multiparity ≥ 3 was more frequent in CUR (31 versus 10.7%, p  = 0.020). Factors increasing the risk for CUR were parity ≥ 3 (OR = 3.8, p  = 0.025), previous vaginal birth (OR = 4.4, p  = 0.011), TOLAC (OR = 6.5, p