Uterine rupture during VBAC trial of labor: risk factors and fetal response.
For the woman with a prior uterine scar, neither repeat elective cesarean birth nor vaginal birth after cesarean birth (VBAC) trial of labor (TOL) is risk-free. When VBAC-TOL is successful, it is associated with less morbidity than repeat cesarean birth. However, when VBAC-TOL fails due to uterine rupture, severe consequences often ensue. The challenge for clinicians today is to provide women who desire TOL after cesarean birth, a more individualized risk assessment of uterine rupture, thereby enhancing success and optimizing outcome. This article examines major risk factors for uterine rupture during VBAC-TOL. In addition, fetal response to uterine rupture and neonatal outcomes are reviewed.
O'brien-Abel
Nancy
N
Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, University of Washington School of Medicine, Seattle, WA 98195-6460, USA.
D000328:Adult; D005260:Female; D006340:Heart Rate, Fetal; D006801:Humans; D007751:Labor, Induced / Q000009:adverse effects / Q000379:methods* / Q000451:nursing; D008880:Midwifery / Q000379:methods*; D010120:Oxytocics / Q000008:administration & dosage / Q000009:adverse effects; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D014219:Trial of Labor; D014481:United States; D014597:Uterine Rupture / Q000139:chemically induced / Q000451:nursing / Q000517:prevention & control; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects / Q000379:methods / Q000451:nursing
D010120:Oxytocics