title: [Risk of uterine rupture in vaginal birth after cesarean: Systematic review].
abstract: OBJECTIVE
  To assess the risk of uterine rupture (UR) in attempted vaginal birth after cesarean and to identify risk factors.
  
  
  METHODS
  Systematic review by consulting the following databases: PubMed (MEDLINE), Cochrane Library Plus, Embase, Nursing@Ovid, Cuidatge and Dialnet. The search was conducted between January and March 2015. MeSH descriptors used were: vaginal birth after cesarean; uterine rupture; labor induced and labor obstetric or trial of labor. There were no restrictions on date or language. The selection of articles was performed by 2 independent reviewers, standardized and unblinded. A critical review of the summary was conducted, and if was necessary, the full text was consulted. Prospective and retrospective documents were included.
  
  
  RESULTS
  A total of 39 documents were included for their relevance and interest. Few clinical trials were found. The UR incidence on the results of the studies analyzed ranged from 0.15-0.98% in spontaneous labor; 0.3-1.5% in stimulation and induction with oxytocin, and 0.68-2.3% in prostaglandin inductions.
  
  
  CONCLUSIONS
  The success of vaginal birth after cesarean is important and improves when conditions are optimal. However it is not without risks, the main one being UR. Induction of labor with oxytocin and/or prostaglandins appears as the main risk factor, while the spontaneous onset of labor and a prior vaginal birth are protective factors.
authors.affiliation: Unidad de Partos, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, España; Facultad de Medicina y Enfermería, Universidad de Córdoba, Córdoba, España. Electronic address: phlopezosa@uco.es.
authors.forename: Pedro
authors.initials: P
authors.lastname: Hidalgo-Lopezosa
authors.affiliation: Facultad de Medicina y Enfermería, Universidad de Córdoba, Córdoba, España.
authors.forename: María
authors.initials: M
authors.lastname: Hidalgo-Maestre
mesh_terms: D005260:Female; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology*; D011247:Pregnancy; D018570:Risk Assessment; D012307:Risk Factors; D014597:Uterine Rupture / Q000453:epidemiology* / Q000209:etiology; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects
keywords: Labor induced; Parto inducido; Parto vaginal después de cesárea; Rotura uterina; Trabajo de parto; Trial of labor; Uterine rupture; Vaginal birth after cesarean