Abstract
Objective: To study the outcomes of new pregnancies after
previous complete uterine rupture.
Design: Descriptive study based on population data from the
Medical Birth Registry of Norway, the Patient Administration System, and
medical records.
Sample : Maternities with 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 new
complete rupture was 0% in those with previous rupture in the LS, and
8.6% in 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 previous
complete uterine rupture is favorable. Prematurity is a problem caused
by both obstetrician and mother anxiety, so the timing of delivery is
most challenging. Careful counseling, vigilance for symptoms, and
immediate delivery are most important.