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Women who have a vaginal delivery after a caesarean section face
three times the risk of uterine rupture than those who have a second
caesarean section, a new report has said (New England Journal of
Medicine 2001;345:3-8).
Moreover, the risk of rupture was five times greater in women whose
labour was induced by prostaglandins than in those whose labour was spontaneous.
Researchers at the University of Washington in Seattle reached these
conclusions from a retrospective cohort analysis of 20095 women who
delivered their first baby via caesarean section and then had a second child.
Ninety one cases of uterine rupture overall were recorded. Uterine
rupture occurred in 1.6 per 1000 deliveries among women with a repeat
caesarean delivery without labour (11 women) and in 24.5 per 1000 deliveries among women with prostaglandin induced labour (9 women).
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