Pregnancies in Women with a Previous Complete Uterine Rupture.

IF 1.6 Q3 OBSTETRICS & GYNECOLOGY
Obstetrics and Gynecology International Pub Date : 2023-02-09 eCollection Date: 2023-01-01 DOI:10.1155/2023/9056489
Iqbal Al-Zirqi, Siri Vangen
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引用次数: 0

Abstract

Objective: To study the outcomes of new pregnancies after a previous complete uterine rupture.

Design: Descriptive study based on population data from the Medical Birth Registry of Norway, the Patient Administration System, and the medical records. Sample. Maternities with a previous complete uterine rupture in Norway during the period 1967-2011 (N = 72), extracted from 2 455 797 maternities.

Method: We measured the rate of new complete ruptures and partial ruptures, as well as the maternal and perinatal outcomes of these pregnancies. The characteristics of both previous ruptures and new ruptures were described.

Results: Among 72 maternities, there were thirty-seven with previous ruptures in the lower segment (LS) and 35 outside the LS. We found three new complete ruptures and six uneventful partial ruptures, resulting in a rate of 4.2% and 8.3%, respectively. All three complete ruptures occurred preterm in scars outside the LS. The rate of the new complete rupture was 0% in those with previous ruptures in the LS and 8.6% in those with previous ruptures outside the LS. The corrected perinatal mortality was 1.3%, and prematurity (<37 weeks) was high (36.1%); this was noticed even in the absence of new ruptures and was mostly iatrogenic. Two hysterectomies were performed in the absence of rupture and two cases had abnormal invasive placenta.

Conclusion: The prognosis for pregnancies after a previous complete uterine rupture is favorable. Prematurity is a problem caused by both obstetrician and mother's anxiety; therefore, the timing of delivery is the most challenging. Management should include careful counseling, vigilance for symptoms, and immediate delivery when a rupture is suspected.

曾发生子宫完全破裂的妇女怀孕。
目的研究子宫完全破裂后新妊娠的结果:描述性研究基于挪威出生医学登记处、患者管理系统和医疗记录中的人口数据。样本。1967-2011年间挪威曾发生子宫完全破裂的产妇(N = 72),从2 455 797名产妇中抽取:我们测量了新的子宫完全破裂和部分破裂率,以及这些妊娠的产妇和围产期结局。结果:在 72 例产妇中,有 1 例完全破裂,1 例部分破裂:结果:在 72 名产妇中,有 37 名曾在下段(LS)发生过破裂,35 名在 LS 以外。我们发现了 3 例新的完全破裂和 6 例不严重的部分破裂,破裂率分别为 4.2% 和 8.3%。所有三例完全破裂都发生在 LS 外侧疤痕的早产期。曾在LS内发生过破裂的产妇的新发完全破裂率为0%,曾在LS外发生过破裂的产妇的新发完全破裂率为8.6%。经校正的围产期死亡率为 1.3%,早产率为 1.5%:曾发生子宫完全破裂的孕妇预后良好。早产是产科医生和母亲焦虑造成的问题;因此,分娩时机的选择是最具挑战性的。处理方法应包括仔细咨询、警惕症状,以及在怀疑子宫破裂时立即分娩。
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来源期刊
Obstetrics and Gynecology International
Obstetrics and Gynecology International OBSTETRICS & GYNECOLOGY-
CiteScore
3.60
自引率
0.00%
发文量
26
审稿时长
19 weeks
期刊介绍: Obstetrics and Gynecology International is a peer-reviewed, Open Access journal that aims to provide a forum for scientists and clinical professionals working in obstetrics and gynecology. The journal publishes original research articles, review articles, and clinical studies related to obstetrics, maternal-fetal medicine, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine and infertility, reproductive endocrinology, and sexual medicine.
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