Outcome of subsequent pregnancies post uterine rupture in previous delivery: A case series, a review, and recommendations for appropriate management

Yohann Dabi*, Jerome Bouaziz, Yechiel Burke, Alba Nicolas-Boluda, Anne Gael Cordier, Jennifer Chayo, Shlomo B. Cohen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To provide clinicians with concrete solutions on the best management of and counseling for patients in a subsequent pregnancy following uterine rupture. Methods: A retrospective analysis of patients treated between 2005 and 2020 at Sheba Medical Center was conducted. All patients who had undergone a complete uterine rupture and subsequently had a full-term pregnancy were included. A literature review was conducted using Pubmed database and including previously published literature reviews. Results: Fifteen patients with subsequent pregnancies following uterine rupture were included in our cohort. Mean interval between rupture and subsequent pregnancy was 3.8 years (range 2.2–6.9 years). One patient had repeat uterine rupture of less than 2 cm at 36+5 weeksof pregnancy. A total of 17 studies were selected in this literature review, including a total of 774 pregnancies in 635 patients. The risk of repeated uterine rupture was 8.0% (62/774), ranging from 0% to 37.5%. Overall, the risk of maternal death was of 0.6% (4/635), with only four cases reported in three studies. Conclusion: The risk of recurrence after uterine rupture is significant but should not prevent patients from conceiving.

Original languageEnglish
Pages (from-to)204-217
Number of pages14
JournalInternational Journal of Gynecology and Obstetrics
Volume161
Issue number1
DOIs
StatePublished - Apr 2023
Externally publishedYes

Keywords

  • repeat
  • subsequent pregnancy
  • uterine rupture
  • uterine ruptureCesarean scar

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