title: An audit about labour induction, using prostaglandin, in women with a scarred uterus.
abstract: OBJECTIVE
  Induction of labour after a previous caesarean section is still controversial. We aim to analyse, in a population of women who have a uterine scar, the maternal, foetal and neonatal complications in relation to the mode of labour and delivery.
  
  
  METHODS
  Retrospective analysis of collected data from all the singleton deliveries of patients with a scarred uterus (N=798), admitted to the hospital between August 2006 and March 2009.
  
  
  RESULTS
  maternal and perinatal complications.
  
  
  RESULTS
  Among 798 singleton deliveries, 36.1% had a spontaneous labour, 12.6% a prostaglandin-induced labour and 2.9% an ocytocin-induced labour, and 48.4% had an elective caesarean section. The chance of delivering vaginally was respectively 84.4% for those who had a spontaneous labour, 75.2% for those who were induced using prostaglandin, 82.6% after induction using ocytocin. There were eight uterine ruptures, four after spontaneous labour (1.4%), two after prostaglandin induction (2%) and two at the time of an iterative caesarean section (0.5%). There were no differences between groups, except the risk of haemorrhage (17.4% after spontaneously induced labour, 34.8% after ocytocin, 17.8% after prostaglandin and 44.6% after iterative caesarean section; p<0.005) and the neonatal admissions when analysed by intention to treat only (8.3% after spontaneously induced labour, 9.1% after ocytocin, 12% after prostaglandin and 16.8% after iterative caesarean section; p<0.009).
  
  
  CONCLUSIONS
  Although no increase in maternal or perinatal outcome was observed in relation to prostaglandin-induced labour after caesarean section, this study is too underpowered to exclude an increased risk.
authors: Department of Obstetrics and Gynaecology, C.H.U. Saint-Pierre, Université Libre de Bruxelles, Hoog Str 322, 1000, Brussels, Belgium.
authors: Alexandra
authors: A
authors: Cogan
authors: Patricia
authors: P
authors: Barlow
authors: Nordine
authors: N
authors: Benali
authors: Daniel
authors: D
authors: Murillo
authors: Yannick
authors: Y
authors: Manigart
authors: Julie
authors: J
authors: Belhomme
authors: Serge
authors: S
authors: Rozenberg
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects; D016009:Chi-Square Distribution; D002921:Cicatrix / Q000150:complications; D005260:Female; D006801:Humans; D015931:Intensive Care, Neonatal; D057194:Intention to Treat Analysis; D007751:Labor, Induced / Q000009:adverse effects* / Q000379:methods; D007743:Labor, Obstetric; D016015:Logistic Models; D008485:Medical Audit; D007744:Obstetric Labor Complications / Q000139:chemically induced*; D010120:Oxytocics / Q000008:administration & dosage* / Q000009:adverse effects; D010121:Oxytocin / Q000008:administration & dosage / Q000009:adverse effects; D019106:Postoperative Hemorrhage / Q000209:etiology*; D011247:Pregnancy; D011453:Prostaglandins / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D014597:Uterine Rupture / Q000209:etiology; D014599:Uterus / Q000473:pathology / Q000601:surgery
chemical_list: D010120:Oxytocics; D011453:Prostaglandins; D010121:Oxytocin