title: Uterine rupture.
abstract: OBJECTIVE
  The increasing rates of primary caesarean section are likely to contribute to a rise in the incidence of uterine rupture in developed countries. Uterine rupture continues to be an important cause of maternal death in less and least developed countries. Recent publications adressing the diagnosis, aetiology and management of primary caesarian section are reviewed.
  
  
  RESULTS
  Uterine rupture is commonly associated with vaginal birth after caesarean section, although the absolute risk varies according to previous obstetric history, gestational age, and induction of labour. Quantification of risk for a range of circumstances allows informed counselling of pregnant women. Imaging techniques may improve the early detection of uterine dehiscence but in the acute setting abnormal fetal heart rate patterns provide early diagnostic information. The scale of the problem in less and least developed countries is sobering and maternal mortality can be determined by the ability to access basic obstetric care.
  
  
  CONCLUSIONS
  Uterine rupture remains one of the most frightening complications in obstetric care. The risk of its occurrence is likely to increase for many parous women, placing the emphasis on counselling and early prediction and prevention wherever possible.
authors.affiliation: Division of Maternal and Child Health Sciences, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK. d.j.Murphy@dundee.ac.uk
authors.forename: Deirdre J
authors.initials: DJ
authors.lastname: Murphy
mesh_terms: D005260:Female; D006801:Humans; D016595:Misoprostol / Q000009:adverse effects; D016017:Odds Ratio; D010120:Oxytocics / Q000009:adverse effects; D012307:Risk Factors; D016216:Ultrasonography, Prenatal; D014597:Uterine Rupture / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control*; D014599:Uterus / Q000002:abnormalities; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects; D014947:Wounds and Injuries / Q000150:complications
chemical_list: D010120:Oxytocics; D016595:Misoprostol