Risk of uterine rupture in labor induction of patients with prior cesarean section: an inner city hospital experience.
OBJECTIVE
This study was undertaken to determine the risk of uterine rupture in patients induced with oxytocin or misoprostol after 1 or more previous cesarean sections.


METHODS
Patients with 1 or more previous cesarean sections who delivered after 28 weeks' gestation between 1996 and 2002 were identified by database. Among 3533 total patients, rates of uterine rupture were compared among 4 groups: oxytocin induction (n = 430), misoprostol induction (n = 142), spontaneous labor (n = 2523), and repeat cesarean section without labor (n = 438). Statistical analysis included chi(2) test, Fisher exact test, unpaired t test, and Mantel-Haenszel test.


RESULTS
Rate of rupture was increased in all inductions compared with that of the spontaneous labor group. Among patients with 1 prior cesarean, rupture rates with misoprostol and oxytocin induction were 0.8% and 1.1%, respectively.


CONCLUSIONS
Induction of labor with oxytocin or misoprostol is associated with a higher rate of uterine rupture compared with those who deliver after spontaneous labor. After 1 prior cesarean, rupture rate with misoprostol induction is not increased compared with oxytocin induction.
Lin
Carol
C
Department of Gynecology and Obstetrics, Emory University at Grady Healthcare System, Atlanta, GA, USA.
Raynor
B Denise
BD
D000328:Adult; D016001:Confidence Intervals; D005260:Female; D005865:Gestational Age; D006786:Hospitals, Urban; D006801:Humans; D015994:Incidence; D007751:Labor, Induced / Q000009:adverse effects* / Q000379:methods; D016595:Misoprostol / Q000008:administration & dosage*; D016017:Odds Ratio; D010121:Oxytocin / Q000008:administration & dosage*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D018570:Risk Assessment; D014219:Trial of Labor; D014597:Uterine Rupture / Q000453:epidemiology* / Q000209:etiology*; D016064:Vaginal Birth after Cesarean
D016595:Misoprostol; D010121:Oxytocin