Uterine rupture and its complications in the Netherlands: a prospective study.
OBJECTIVE
To determine maternal and perinatal morbidity and mortality after uterine rupture in the Netherlands.


METHODS
All 100 Dutch obstetric departments were asked to participate in a prospective nationwide registration of uterine rupture between 1st April 2002 and 1st April 2003. For every case, a questionnaire about obstetrical history, current pregnancy and delivery, maternal and neonatal outcome was completed.


RESULTS
Eighty-nine percent of all hospitals in the Netherlands participated. Ninety-eight uterine ruptures were registered; 95 after a previous caesarean section (CS) of which 91 occurred during a trial of labour. The fetus was extruded in the abdominal cavity completely in 18 cases and partially in 13 cases. Major complications due to uterine rupture were: perinatal death (n=11, from 94 cases with a viable fetus, 11.7%) and hysterectomy (n=4, 4.1%).


CONCLUSIONS
These severe complications, perinatal death and hysterectomy, have to be an issue when counselling women on an elective CS and women with a history of a CS on the route of delivery.
University Medical Centre Utrecht, Department of Obstetrics and Gynaecology, Utrecht, The Netherlands. a.kwee@azu.nl
Anneke
A
Kwee
Michiel L
ML
Bots
Gerard H A
GH
Visser
Hein W
HW
Bruinse
D002585:Cesarean Section / Q000009:adverse effects; D005260:Female; D005313:Fetal Death / Q000453:epidemiology* / Q000209:etiology; D019538:Health Care Surveys; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D007231:Infant, Newborn; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D011446:Prospective Studies; D014597:Uterine Rupture / Q000401:mortality*; D016064:Vaginal Birth after Cesarean