True rupture of the caesarean section scar (a 15 year review, 1972-1987).
In a 15 year period (1972-1987) a total of 2434 parturients with one or more previous Caesarean sections were delivered at University College Hospital, Galway. There were 1084 (44.5%) patients booked for elective repeat Caesarean delivery, because they had two or more prior sections (maximum number = 10) or a recurrent indication for section other than the prior section. Trial of labour was undertaken in 1350 (55.5%) patients, and 81.26% achieved a vaginal delivery. Regional analgesia was employed in 25.5% and oxytocin in 31.9%. There were 6 (0.44%) or 1:225, true scar ruptures, resulting in 1 stillbirth and 2 neonatal deaths with no maternal death. There were 4 (0.37%), or 1:271, uterine ruptures in patients booked for elective repeat section: a classical scar rupture before labour, with a fresh stillbirth; placenta praevia percreta with bladder involvement in two patients (both resulting in maternal death), and a patient with placenta praevia accreta.
Meehan
F P
FP
Department of Obstetrics and Gynaecology, University College, Galway, Ireland.
Magani
I M
IM
D000765:Anesthesia, Conduction; D000773:Anesthesia, Obstetrical; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007751:Labor, Induced; D010121:Oxytocin; D011247:Pregnancy; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D014219:Trial of Labor; D014597:Uterine Rupture / Q000453:epidemiology*
D010121:Oxytocin