title: Contemporary analysis of maternal and neonatal morbidity after uterine rupture: A nationwide population-based study.
abstract: OBJECTIVE
  Uterine rupture is a rare but feared perinatal event. Despite abundant research and changes to guidelines implemented to reduce this complication, evaluation of whether uterine rupture still engenders significant maternal/neonatal morbidity has not been conducted. We analyzed recent cases of maternal/neonatal morbidity after uterine rupture.
  
  
  METHODS
  Deliveries complicated by uterine rupture from 2011 to 2012 in the United States were selected. Comparison cases without uterine rupture were used as controls. Measures of maternal/neonatal complications were compared with χ2test, and relative risks were calculated. Logistic regression was used to identify the most significant complications. P < 0.05 indicated statistical significance.
  
  
  RESULTS
  From 7 922 016 births, 1925 cases of uterine rupture and 3765 controls were identified. Regression models retained four maternal outcomes; blood transfusion was the most common (~15%) and unplanned hysterectomy had the highest odds (~97-fold). For newborns, the model retained three measures of morbidity; neonatal intensive care unit admission was the most common (~35%) and seizures had the highest odds (~20-fold).
  
  
  CONCLUSIONS
  Despite efforts to reduce complications, mothers remain at significant risk of unplanned hysterectomy and intensive care unit admission. Neonates are at sizeable risk for neonatal intensive care unit admission and seizures, recognized markers of long-term neurobehavioral abnormality. Uterine rupture remains a major risk for mothers and babies.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Vilchez
authors.affiliation: Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA.
authors.forename: Jing
authors.initials: J
authors.lastname: Dai
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.
authors.forename: Komal
authors.identifier: http://orcid.org/0000-0003-0748-213X
authors.initials: K
authors.lastname: Kumar
authors.affiliation: School of Biomedical Sciences, Federico Villarreal National University, Lima, Peru.
authors.forename: Moraima
authors.initials: M
authors.lastname: Lagos
authors.affiliation: Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Sokol
mesh_terms: D000328:Adult; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology*; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data*; D011247:Pregnancy; D011644:Puerperal Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014597:Uterine Rupture / Q000453:epidemiology*
keywords: blood transfusion; hysterectomy; neonatal seizure; newborn disease; pregnancy complication; uterine rupture