title: Vaginal birth after cesarean section: risk of uterine rupture with labor induction.
abstract: We assessed the rate of uterine rupture in patients undergoing labor induction for attempted vaginal birth after cesarean (VBAC). A retrospective study was performed of data from a computerized database. Deliveries from January 1, 1998, to June 30, 2001, in the Southern California Kaiser Permanente system were reviewed and various perinatal characteristics analyzed. A total of 16,218 patients had a prior low transverse cesarean section. Of these, 6832 (42.1%) had a trial of labor. Successful VBAC occurred in 86% of patients with spontaneous onset of labor and 66% of patients with labor induction ( p < 0.001). The uterine rupture rate was not different between patients with spontaneous or induced labor (1.0% versus 1.2%, p = 0.51). Similarly, there was no significant difference between oxytocin or prostaglandin E2 induction (1.4% versus 1.0%, p = 0.59). In our study, labor induction did not appear to increase the risk of uterine rupture in women attempting VBAC.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, USA. jouzouni@usc.edu
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Ouzounian
authors.forename: David A
authors.initials: DA
authors.lastname: Miller
authors.forename: Christy J
authors.initials: CJ
authors.lastname: Hiebert
authors.forename: Leah R
authors.initials: LR
authors.lastname: Battista
authors.forename: Richard H
authors.initials: RH
authors.lastname: Lee
mesh_terms: D000328:Adult; D015232:Dinoprostone / Q000009:adverse effects; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000009:adverse effects*; D010120:Oxytocics / Q000009:adverse effects; D010121:Oxytocin / Q000009:adverse effects; D011247:Pregnancy; D012189:Retrospective Studies; D014219:Trial of Labor; D014597:Uterine Rupture / Q000453:epidemiology / Q000209:etiology*; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D010120:Oxytocics; D010121:Oxytocin; D015232:Dinoprostone