title: The pattern of labor preceding uterine rupture.
abstract: OBJECTIVE
  We sought to characterize the labor of women attempting trial of labor after cesarean (TOLAC) who experience uterine rupture.
  
  
  METHODS
  We conducted a secondary analysis of a nested case-control study of women attempting TOLAC. Women experiencing uterine rupture (cases) were compared to 2 reference groups: successful TOLAC and failed TOLAC. Interval-censored regression was used to estimate the median time to progress 1 cm in dilation and the total time from 4-10 cm.
  
  
  RESULTS
  A total of 115 cases were compared to 341 successful TOLAC and 120 failed TOLAC. The time to progress 1 cm was similar between groups until 7-cm dilation. After 7 cm, cases of uterine rupture required longer to progress than successful TOLAC (median [95th percentile] time from 7-8 cm: 0.38 [1.91] vs 0.16 [0.79] hours; from 8-9 cm: 0.28 [1.10] vs 0.10 [0.39] hours). Women with a uterine rupture had labor curves similar to those with a failed TOLAC.
  
  
  CONCLUSIONS
  Women with labor dystocia in the active phase of labor should be closely monitored for uterine rupture in TOLAC.
authors: Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
authors: Lorie M
authors: LM
authors: Harper
authors: Alison G
authors: AG
authors: Cahill
authors: Kimberly A
authors: KA
authors: Roehl
authors: Anthony O
authors: AO
authors: Odibo
authors: David M
authors: DM
authors: Stamilio
authors: George A
authors: GA
authors: Macones
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies; D014219:Trial of Labor; D014597:Uterine Rupture / Q000503:physiopathology*; D016064:Vaginal Birth after Cesarean