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Pregnancies in women with previous complete uterine ruptures
  • Iqbal Al-Zirqi,
  • Siri Vangen
Iqbal Al-Zirqi
Oslo Unuversity Hospital,Rikshospitalet

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Siri Vangen
Norwegian National Advisory Unit on Women’s Health
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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.
21 Mar 2022Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
28 Mar 2022Submission Checks Completed
28 Mar 2022Assigned to Editor
04 Apr 2022Reviewer(s) Assigned
23 Jun 2022Review(s) Completed, Editorial Evaluation Pending