Previous preterm cesarean delivery and risk of uterine rupture in subsequent trial of labor
American Journal of Obstetrics and Gynecology Oct 01, 2020
Mantel A, Ajne G, Wollmann CL, et al. - Via performing a population-based cohort study, the risk of uterine rupture among women attempting trial of labor after one previous preterm cesarean vs women with one previous term cesarean was investigated. From the Swedish Medical Birth Register (between 1983 and 2016), they identified 9,300 women with one previous preterm index-cesarean, 57,168 women with one prior term index-cesarean and a second outcome-delivery defined as trial of labor after one previous cesarean delivery. Uterine rupture in the outcome-delivery occurred in 102 (1.1%) women with a preterm index-cesarean compared with 759 (1.4%) of women with term index-cesarean. Overall findings do not suggest association of preterm cesarean with an increased risk of uterine rupture. Hence, they emphasize providing similar medical management and counselling to women with one prior preterm cesarean (with lower uterine segment incision) vs women with prior term cesarean prior to trial of labor after cesarean.
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