Uterine rupture and perinatal outcome.

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.