Intrapartum predictors of uterine rupture.
This case-controlled study reviewed 26 cases of uterine rupture at an academic medical center. Controls were selected in a 2:1 design by reviewing the immediate successful vaginal birth after cesarean delivery (VBAC) before and after each case of uterine rupture. At less than 2 hours before delivery or acute uterine rupture, mild and severe variable decelerations, persistent abdominal pain, and hyperstimulation were more common in cases of uterine rupture as compared to controls and had statistically significant positive likelihood ratios (LR). Mild and severe variable fetal heart rate decelerations, especially in the presence of persistent abdominal pain, may predict uterine rupture in patients attempting VBAC.
Craver Pryor
Elizabeth
E
Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA.
Mertz
Heather L
HL
Beaver
Brittian W
BW
Koontz
Gretchen
G
Martinez-Borges
Anibal
A
Smith
Jennifer G
JG
Merrill
David
D
D000046:Academic Medical Centers; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006340:Heart Rate, Fetal; D006801:Humans; D008499:Medical Records; D009657:North Carolina / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D012307:Risk Factors; D014597:Uterine Rupture / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D016064:Vaginal Birth after Cesarean