Uterine Rupture Trends in Patients Pursuing Trial of Labor After Cesarean in the United States from 2010 to 2022.

IF 4.7 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Obstetrics and gynecology Pub Date : 2025-05-01 Epub Date: 2025-03-13 DOI:10.1097/AOG.0000000000005882
Lillian H Goodman, Amanda A Allshouse, Torri D Metz, Ann M Bruno
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引用次数: 0

Abstract

National rates of trial of labor after cesarean (TOLAC) have increased, but the risk of uterine rupture remains. Clinical practice- and patient-level changes also have occurred in the past decade, and an evaluation of contemporary uterine rupture rates is needed. Using natality files available in the National Vital Statistics System from 2010 to 2022, we conducted a repeated cross-sectional analysis to evaluate U.S. trends in uterine rupture and perinatal outcomes among individuals undertaking TOLAC. Temporal trends were characterized using joinpoint regression, with average annual percent change (AAPC) and 95% CI reported. There were 2,888 uterine ruptures (0.28%) among 1,016,073 included deliveries. The rate of uterine rupture increased over time, from 0.20% in 2010 to 0.37% in 2022 (AAPC 6.2, 95% CI, 4.3-8.7). Although rates of uterine rupture increased over time, it remains a rare event with a low absolute risk.

2010 - 2022年美国剖宫产术后尝试分娩患者子宫破裂趋势
全国剖宫产后试产率(TOLAC)有所增加,但子宫破裂的风险仍然存在。在过去的十年中,临床实践和患者水平也发生了变化,需要对当代子宫破裂率进行评估。使用2010年至2022年国家生命统计系统中的出生档案,我们进行了重复的横断面分析,以评估美国接受TOLAC的个体子宫破裂和围产期结局的趋势。时间趋势用连接点回归表征,报告平均年变化百分比(AAPC)和95% CI。1,016,073例分娩中子宫破裂2,888例(0.28%)。子宫破裂率随时间增加,从2010年的0.20%增加到2022年的0.37% (AAPC 6.2, 95% CI, 4.3-8.7)。虽然子宫破裂率随着时间的推移而增加,但它仍然是一种罕见的事件,绝对风险低。
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来源期刊
Obstetrics and gynecology
Obstetrics and gynecology 医学-妇产科学
CiteScore
11.10
自引率
4.20%
发文量
867
审稿时长
1 months
期刊介绍: "Obstetrics & Gynecology," affectionately known as "The Green Journal," is the official publication of the American College of Obstetricians and Gynecologists (ACOG). Since its inception in 1953, the journal has been dedicated to advancing the clinical practice of obstetrics and gynecology, as well as related fields. The journal's mission is to promote excellence in these areas by publishing a diverse range of articles that cover translational and clinical topics. "Obstetrics & Gynecology" provides a platform for the dissemination of evidence-based research, clinical guidelines, and expert opinions that are essential for the continuous improvement of women's health care. The journal's content is designed to inform and educate obstetricians, gynecologists, and other healthcare professionals, ensuring that they stay abreast of the latest developments and best practices in their field.
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