Pregnancies in Women with a Previous Complete Uterine Rupture

Objective. To study the outcomes of new pregnancies after a previous complete uterine rupture. Design. Descriptive study based on population data from the Medical Birth Registry of Norway, the Patient Administration System, and the medical records. Sample. Maternities with a previous complete uterin...

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Main Authors: Iqbal Al-Zirqi, Siri Vangen
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Obstetrics and Gynecology International
Online Access:http://dx.doi.org/10.1155/2023/9056489
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author Iqbal Al-Zirqi
Siri Vangen
author_facet Iqbal Al-Zirqi
Siri Vangen
author_sort Iqbal Al-Zirqi
collection DOAJ
description Objective. To study the outcomes of new pregnancies after a previous complete uterine rupture. Design. Descriptive study based on population data from the Medical Birth Registry of Norway, the Patient Administration System, and the medical records. Sample. Maternities with a previous complete uterine rupture in Norway during the period 1967–2011 (N = 72), extracted from 2 455 797 maternities. Method. We measured the rate of new complete ruptures and partial ruptures, as well as the maternal and perinatal outcomes of these pregnancies. The characteristics of both previous ruptures and new ruptures were described. Results. Among 72 maternities, there were thirty-seven with previous ruptures in the lower segment (LS) and 35 outside the LS. We found three new complete ruptures and six uneventful partial ruptures, resulting in a rate of 4.2% and 8.3%, respectively. All three complete ruptures occurred preterm in scars outside the LS. The rate of the new complete rupture was 0% in those with previous ruptures in the LS and 8.6% in those with previous ruptures outside the LS. The corrected perinatal mortality was 1.3%, and prematurity (<37 weeks) was high (36.1%); this was noticed even in the absence of new ruptures and was mostly iatrogenic. Two hysterectomies were performed in the absence of rupture and two cases had abnormal invasive placenta. Conclusion. The prognosis for pregnancies after a previous complete uterine rupture is favorable. Prematurity is a problem caused by both obstetrician and mother’s anxiety; therefore, the timing of delivery is the most challenging. Management should include careful counseling, vigilance for symptoms, and immediate delivery when a rupture is suspected.
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spelling doaj-art-e9172eac6ab84472a5932c40e53d23ec2025-02-03T06:04:52ZengWileyObstetrics and Gynecology International1687-95972023-01-01202310.1155/2023/9056489Pregnancies in Women with a Previous Complete Uterine RuptureIqbal Al-Zirqi0Siri Vangen1Norwegian Research Center for Women’s HealthNorwegian Research Center for Women’s HealthObjective. To study the outcomes of new pregnancies after a previous complete uterine rupture. Design. Descriptive study based on population data from the Medical Birth Registry of Norway, the Patient Administration System, and the medical records. Sample. Maternities with a previous complete uterine rupture in Norway during the period 1967–2011 (N = 72), extracted from 2 455 797 maternities. Method. We measured the rate of new complete ruptures and partial ruptures, as well as the maternal and perinatal outcomes of these pregnancies. The characteristics of both previous ruptures and new ruptures were described. Results. Among 72 maternities, there were thirty-seven with previous ruptures in the lower segment (LS) and 35 outside the LS. We found three new complete ruptures and six uneventful partial ruptures, resulting in a rate of 4.2% and 8.3%, respectively. All three complete ruptures occurred preterm in scars outside the LS. The rate of the new complete rupture was 0% in those with previous ruptures in the LS and 8.6% in those with previous ruptures outside the LS. The corrected perinatal mortality was 1.3%, and prematurity (<37 weeks) was high (36.1%); this was noticed even in the absence of new ruptures and was mostly iatrogenic. Two hysterectomies were performed in the absence of rupture and two cases had abnormal invasive placenta. Conclusion. The prognosis for pregnancies after a previous complete uterine rupture is favorable. Prematurity is a problem caused by both obstetrician and mother’s anxiety; therefore, the timing of delivery is the most challenging. Management should include careful counseling, vigilance for symptoms, and immediate delivery when a rupture is suspected.http://dx.doi.org/10.1155/2023/9056489
spellingShingle Iqbal Al-Zirqi
Siri Vangen
Pregnancies in Women with a Previous Complete Uterine Rupture
Obstetrics and Gynecology International
title Pregnancies in Women with a Previous Complete Uterine Rupture
title_full Pregnancies in Women with a Previous Complete Uterine Rupture
title_fullStr Pregnancies in Women with a Previous Complete Uterine Rupture
title_full_unstemmed Pregnancies in Women with a Previous Complete Uterine Rupture
title_short Pregnancies in Women with a Previous Complete Uterine Rupture
title_sort pregnancies in women with a previous complete uterine rupture
url http://dx.doi.org/10.1155/2023/9056489
work_keys_str_mv AT iqbalalzirqi pregnanciesinwomenwithapreviouscompleteuterinerupture
AT sirivangen pregnanciesinwomenwithapreviouscompleteuterinerupture