gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

Rupture of the uterine scar after a prior cesarean delivery-analysis



Introduction. Thirty years of observations revealed that performing cesarean section increasesthe number of women with the obstetric history of previous one or more cesarean section. Asa result, a problem has occurred in group of women after prior cesarean delivery in the nextlabor, there is a high risk of uterine scar rupture.Materials end methods. We retrospectively reviewed the medical records of 764 patients de-livered after prior low transverse cesarean delivery over 11-year of hospital period from 1992-2002 at Hospital in Chojnice. The purpose of this study was to retrospectively analyze theincidence of rupture of the uterine scar in women delivered after previous cesarean delivery.Statistical comparisons were performed using test Z. Statistical significance was defined asp<0.05.Results.Overall 1,0% uterine rupture occured among 764 women after low transverese cesa-rean delivery. There were observed 0,5% of complete uterine rupture and 0,5% of uterinedehicence. The incidence of uterine rupture in a trial-of-labor group was not elevated, com-pared with an elective cesarean group. The rate of uterine rupture detected at cesarean deli-very performed for suspected uterine rupture in comparison of cesarean group performed forother indications was non significantly different. 62% of the overall cases of uterine rupturewas observed before the onset of labor and 60% of them were cases of scar dehicence detec-ted in women delivered by elective cesarean.Conclusions. A clinical sings of uterine rupture are not specific predictors of clinically suspectedor beginning uterine rupture. The routine sonographic assessment of the lower uterine segmentin women with previous cesarean delivery with term pregnancy appears to be useful to de-termine on mode of delivery. The trial of labor after prior cesarean delivery is not associatedwith an increased rate of uterine rupture.