Neonatal neurological morbidity associated with uterine rupture.
OBJECTIVE
To compare neonatal neurological morbidity associated with uterine rupture with morbidity associated with a non-reassuring fetal status.


METHODS
We conducted a retrospective cohort analysis. Twenty-one cases of term infants delivered after a symptomatic uterine rupture were analyzed and compared with a randomly selected group of 63 infants born after a non-reassuring fetal heart rate pattern.


RESULTS
Prevalence of uterine rupture was 0.058%. Maternal factors and infant general data were similar in both groups. Infants delivered after a uterine rupture had lower Apgar scores at 1 and 5 min, lower umbilical blood pH, and required more advanced resuscitation than infants delivered after a non-reassuring fetal status. Prevalence of hypoxic-ischemic encephalopathy in the uterine rupture group was 33%, compared with 5% in the other group (P<0.01, relative risk 3.7). Four infants in the uterine rupture group (19%) had moderate or severe encephalopathy; all of them had also multisystem dysfunction and an adverse outcome. No infant in the non-reassuring fetal status group showed moderate or severe encephalopathy.


CONCLUSIONS
Uterine rupture is a considerable sentinel event that involves a high rate of early and late neurological morbidity in the newborn infant.
Martínez-Biarge
Miriam
M
Department of Pediatrics, Neonatology Division, La Paz University Hospital, Madrid, Spain.
García-Alix
Alfredo
A
García-Benasach
Fátima
F
Gayá
Francisco
F
Alarcón
Ana
A
González
Antonio
A
Quero
José
J
D000138:Acidosis / Q000150:complications; D000328:Adult; D001034:Apgar Score; D001925:Brain Damage, Chronic / Q000150:complications*; D015331:Cohort Studies; D005260:Female; D005316:Fetal Distress / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications* / Q000175:diagnosis; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis; D011247:Pregnancy; D012189:Retrospective Studies; D012306:Risk; D012720:Severity of Illness Index; D047929:Term Birth; D014597:Uterine Rupture