title: Underreporting of complete uterine rupture and uterine dehiscence in women with previous cesarean section.
abstract: OBJECTIVE
  To determine the true incidence of complete uterine rupture and uterine dehiscence among women delivered by cesarean section after a previous cesarean section.
  
  
  METHODS
  Medical records of all women who delivered at University Hospital in Malmö, Sweden, during 2005-2009 (n = 21 420) were retrieved from the electronic patient record system (EPRS). After adjustment for inaccuracies, 716 women who had undergone repeat cesarean section were identified and their operation reports were reviewed. Descriptions of complete uterine rupture or uterine dehiscence in operation reports were compared with diagnoses registered in EPRS with International Classification of Diseases codes version 10 (ICD-10). Sensitivity and specificity of complete uterine rupture registration were calculated.
  
  
  RESULTS
  There were 13 women with a registered diagnosis of uterine rupture. After reviewing medical records of women with repeat cesarean section, seven additional cases of complete uterine rupture, 33 cases of uterine dehiscence and 39 cases of extremely thin myometrium were identified. The incidence of complete uterine rupture and uterine dehiscence for women who delivered by repeat cesarean section was 2.8% and 10.1%, respectively.
  
  
  CONCLUSIONS
  Diagnosis of complete uterine rupture was underreported in the EPRS by 35% and diagnosis of uterine dehiscence was missing in 100% of cases.
authors.affiliation: a Department of Obstetrics and Gynecology , Skåne University Hospital Malmö, Lund University , Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Fogelberg
authors.affiliation: a Department of Obstetrics and Gynecology , Skåne University Hospital Malmö, Lund University , Sweden.
authors.forename: Anton
authors.initials: A
authors.lastname: Baranov
authors.affiliation: a Department of Obstetrics and Gynecology , Skåne University Hospital Malmö, Lund University , Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Herbst
authors.affiliation: a Department of Obstetrics and Gynecology , Skåne University Hospital Malmö, Lund University , Sweden.
authors.forename: Olga
authors.initials: O
authors.lastname: Vikhareva
mesh_terms: D017604:Cesarean Section, Repeat / Q000009:adverse effects* / Q000706:statistics & numerical data; D059019:Clinical Coding; D005260:Female; D006801:Humans; D015994:Incidence; D008499:Medical Records; D011159:Population Surveillance; D011247:Pregnancy; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013529:Surgical Wound Dehiscence / Q000175:diagnosis / Q000453:epidemiology*; D014597:Uterine Rupture / Q000175:diagnosis / Q000453:epidemiology*
keywords: Cesarean section; International Classification of Diseases; repeat cesarean section; uterine dehiscence; uterine rupture