Acta obstetricia et gynecologica Scandinavica · 2007
Uterine rupture and perinatal outcome.
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Pettersson Katarina Widén, Grunewald Charlotta, Thomassen Peter
Аннотация
BACKGROUND: In view of the increasing number of caesarean sections (CS), we wanted to investigate the clinical aspects of uterine rupture including perinatal outcome.
METHODS: A retrospective investigation of 24,181 deliveries at Stockholm South General Hospital between 1999 and 2004. Patient notes from cases with ICD-codes 0710 and 0711 were studied together with charts from previous deliveries and neonatal data from the Paediatric Department.
RESULTS: Some 22 cases of uterine rupture were found, giving an incidence of 0.9 per 1,000 deliveries. In all cases, the diagnosis was confirmed at laparotomy. In 19/22 cases, the rupture occurred in patients with a previous uterine scar, 18 of whom were delivered at term and one at 16 gestational weeks. One case of intrauterine fetal death was noted. Of the remaining 20 newborns, 9 had a 5-min Apgar </=7, one died after 3 days, and one had neurological sequele at follow-up. The remaining 18 newborns were healthy at discharge and up to 1 year of age.
CONCLUSIONS: A previous uterine scar was the single most obvious risk factor. A positive finding was the relatively low risk of long-term post-asphyctic sequele in the newborns.
METHODS: A retrospective investigation of 24,181 deliveries at Stockholm South General Hospital between 1999 and 2004. Patient notes from cases with ICD-codes 0710 and 0711 were studied together with charts from previous deliveries and neonatal data from the Paediatric Department.
RESULTS: Some 22 cases of uterine rupture were found, giving an incidence of 0.9 per 1,000 deliveries. In all cases, the diagnosis was confirmed at laparotomy. In 19/22 cases, the rupture occurred in patients with a previous uterine scar, 18 of whom were delivered at term and one at 16 gestational weeks. One case of intrauterine fetal death was noted. Of the remaining 20 newborns, 9 had a 5-min Apgar </=7, one died after 3 days, and one had neurological sequele at follow-up. The remaining 18 newborns were healthy at discharge and up to 1 year of age.
CONCLUSIONS: A previous uterine scar was the single most obvious risk factor. A positive finding was the relatively low risk of long-term post-asphyctic sequele in the newborns.