Transactions of the Twentieth Annual Meeting of the Society for Maternal-Fetal MedicineAssociation of interpregnancy interval with uterine scar failure in labor: A case-control study☆
Section snippets
Subjects
All patients with a uterine rupture or uterine dehiscence that was discovered at delivery between January 1, 1990, and December 31, 1999, were identified by medical records search and review of labor and delivery logbooks. Uterine rupture was diagnosed in the presence of a full-thickness separation of the uterine wall with or without extrusion of the fetus, umbilical cord, or placenta.5 Uterine dehiscence was diagnosed in the presence of a separation or thinning of the previous uterine scar
Results
Forty-three cases of uterine scar failure (23 cases of uterine rupture and 20 cases of uterine dehiscence) were identified from January 1, 1990, through December 31, 1999. One patient had uterine rupture diagnosed after VBAC that was previously considered successful. The appearance of omentum in the vaginal vault prompted exploratory laparotomy, which confirmed uterine rupture. Medical records documenting all previous uterine incisions were unavailable for 4 patients in the case group (9.3%)
Comment
In our case-control study the patients with uterine scar failure during a VBAC attempt exhibited a shortened interpregnancy interval more frequently than did an appropriately matched control group. As such, interpregnancy interval may function as an independent risk factor for uterine scar failure. Alternatively, selection bias in choosing patients for our control group could have created a group with an unusually long interpregnancy interval. This is unlikely, however, in light of our
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Cited by (66)
Middle eastern college of obstetricians and gynecologists (MCOG) practice guidelines: Role of prediction models in management of trial of labor after cesarean section. Practice guideline no. 05-O-22<sup>✰,✰✰,★,★★</sup>
2023, Journal of Gynecology Obstetrics and Human ReproductionCesarean Scar Pregnancy: Diagnosis and Pathogenesis
2019, Obstetrics and Gynecology Clinics of North AmericaInfluence of Caesarean section–pregnancy interval on uterine rupture risk and IVF pregnancy rates: systematic review and mathematical modelling
2019, Reproductive BioMedicine OnlineCitation Excerpt :Most obstetric guidelines recommend an IDI of 18 months to minimize risk of uterine rupture among women with a previous Caesarean section (Kessous and Sheiner, 2013). On the other hand, data regarding the optimal interval between a previous Caesarean section and a trial of labour are not conclusive (Al-Zirqi et al., 2017; Bujold et al., 2002Esposito et al., 2000; Huang et al., 2002; Shipp et al., 2001; Stamilio et al., 2007). Most studies have found an increase in the risk of uterine rupture with a short interpregnancy interval, but the cut-off varies.
N<sup>o</sup> 382 – Épreuve de travail après césarienne
2019, Journal of Obstetrics and Gynaecology CanadaNo. 382-Trial of Labour After Caesarean
2019, Journal of Obstetrics and Gynaecology CanadaCitation Excerpt :Multiple pregnancy is not a contraindication to a trial of labour after Caesarean (II-2B). Six studies with a total of 9040 women have addressed the association between interdelivery interval, TOLAC rates, and uterine rupture risk.100–105 In singleton, term pregnancies with 1 prior Caesarean delivery, VBAC rates do not appear to be related to the interdelivery interval.102
N° 155-Directive clinique sur l'accouchement vaginal chez les patientes ayant déjà subi une césarienne
2018, Journal of Obstetrics and Gynaecology Canada
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Reprint requests: Matthew A. Esposito, MD, Women and Infants’ Hospital, 101 Dudley St, Providence, RI 02905-2499.