Trends, risk factors and pregnancy outcome in women with uterine rupture

Dror Ronel, Arnon Wiznitzer, Ruslan Sergienko, Alexander Zlotnik, Eyal Sheiner*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective This study aimed at determining trends, risk factors and pregnancy outcome in women with uterine rupture. Methods A population-based study, comparing all singleton deliveries with and without uterine rupture between 1988 and 2009 was conducted. Statistical analysis was performed using a multiple logistic regression analysis. Results Uterine rupture occurred in 0.06% (n = 138) of all deliveries included in the study (n = 240,189); 59% in women with a previous cesarean delivery (CD). A gradual increase in the rate of uterine rupture from 1988 (0.01%) to 2009 (0.05%) was noted. Independent risk factors for uterine rupture in a multivariable analysis were: previous CD (OR = 7.4, 95% CI 5.2-10.6), preterm delivery (<37 weeks, OR = 2.5, 95% CI 1.5-4.1), malpresentation (OR = 3.0, 95% CI 1.9-4.5), parity (OR = 1.2, 95% CI 1.1-1.3 for each birth), and dystocia during the Wrst and second stages of labor (OR = 4.1, 95% CI 2.3-7.4 and OR = 11.2, 95% CI 6.7-18.7, respectively). Uterine rupture led to signiWcant maternal morbidity and perinatal mortality. In another multivariable analysis, with perinatal mortality as the outcome variable uterine rupture was noted as an independent risk factor for perinatal mortality (adjusted OR = 17.7; 95% CI 10.0-31.4, P < .01). Conclusions Uterine rupture, associated with previous cesarean delivery, malpresentation, and labor dystocia, is an independent risk factor for perinatal mortality.

Original languageEnglish
Pages (from-to)317-321
Number of pages5
JournalArchives of Gynecology and Obstetrics
Issue number2
StatePublished - Feb 2012
Externally publishedYes


  • Caesarean delivery
  • Maternal morbidity
  • Perinatal mortality
  • Trends in obstetric phenomena
  • Uterine rupture


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