The pattern of labor preceding uterine rupture.

Abstract:

OBJECTIVE:We sought to characterize the labor of women attempting trial of labor after cesarean (TOLAC) who experience uterine rupture. STUDY DESIGN:We conducted a secondary analysis of a nested case-control study of women attempting TOLAC. Women experiencing uterine rupture (cases) were compared to 2 reference groups: successful TOLAC and failed TOLAC. Interval-censored regression was used to estimate the median time to progress 1 cm in dilation and the total time from 4-10 cm. RESULTS:A total of 115 cases were compared to 341 successful TOLAC and 120 failed TOLAC. The time to progress 1 cm was similar between groups until 7-cm dilation. After 7 cm, cases of uterine rupture required longer to progress than successful TOLAC (median [95th percentile] time from 7-8 cm: 0.38 [1.91] vs 0.16 [0.79] hours; from 8-9 cm: 0.28 [1.10] vs 0.10 [0.39] hours). Women with a uterine rupture had labor curves similar to those with a failed TOLAC. CONCLUSION:Women with labor dystocia in the active phase of labor should be closely monitored for uterine rupture in TOLAC.

journal_name

Am J Obstet Gynecol

authors

Harper LM,Cahill AG,Roehl KA,Odibo AO,Stamilio DM,Macones GA

doi

10.1016/j.ajog.2012.06.028

subject

Has Abstract

pub_date

2012-09-01 00:00:00

pages

210.e1-6

issue

3

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(12)00641-2

journal_volume

207

pub_type

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