Risk of uterine rupture among women attempting vaginal birth after cesarean with an unknown uterine scar

Dana Smith, Elizabeth Stringer, Catherine J. Vladutiu, Ashley Hickman Zink, Robert Strauss

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

OBJECTIVE: The purpose of this study was to estimate the association of uterine rupture and previous incision type, either unknown or low transverse, among women who attempt a trial of labor after 1 previous cesarean delivery.

STUDY DESIGN: We conducted a secondary analysis of a prospective multicenter observational study of 15,519 women with term singletons who attempted a trial of labor after 1 previous cesarean delivery. Odds ratios for the association between uterine incision location, either unknown or low transverse, and uterine rupture were estimated with the use of multivariable logistic regression.

RESULTS: Between 1999 and 2002, 99 of the 15,519 women (0.64%) who attempted a trial of labor after 1 previous cesarean delivery experienced a uterine rupture. Pregnant women with an unknown scar had lower odds of uterine rupture (adjusted odds ratio, 0.71; 95% confidence interval, 0.37-1.37) compared with women with a known low transverse scar. Other adverse maternal outcomes did not differ between the 2 groups of women.

CONCLUSION: Among this cohort, women with an unknown uterine incision who attempted a trial of labor were not at increased risk of uterine rupture compared with women with a known low transverse incision.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Volume213
Issue number1
DOIs
StatePublished - Jul 1 2015

Keywords

  • trial of labor
  • unknown scar
  • uterine rupture
  • vaginal birth after cesarean delivery

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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