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Systematic review of the incidence and consequences of uterine rupture in women with previous caesarean section

BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7456.19 (Published 01 July 2004) Cite this as: BMJ 2004;329:19

Data supplement





  • (Posted as supplied by authors)

    Uterine Rupture: Supplementary Table of Included Studies

    Study

    Purpose of Study

    Population

    Sample Size

    Uterine exploration

    Reported outcomes

    Reported associated major morbidty

    Meehan

    198918

    Compare risk between of trial of labor and planned cesarean delivery after a previous cesarean.

    TOL-One prior CD

    ERCD- One or more prior CDs

    I- 127

    A- 217

    SL- 162

    ERCD- 430

    NR

    Symptomatic UR: TOL- 1

    Asymptomatic UR: TOL- 5

    Symptomatic UR: 0 perinatal deaths

    0 maternal deaths

    Blanchette

    199923

    To compare PGE1 (misoprostol) to PGE2 (dinoprostone) for cervical ripening and induction in a community hospital.

    One or more LTCD, not clear what was done with unknown

    PGE1- 16

    PGE2- 9

    NR

    Symptomatic UR: PGE1- 3

    Symptomatic UR: PGE2- 0

    Symptomatic UR: PGE1- 0 maternal deaths, 1 perinatal death, 3 hysterectomies

    Flamm

    198724

    To compare the use of oxytocin for trial of labor in patients with one or more previous cesarean deliveries.

    LTCD and unknown and more than 1 prior

    IA- 485

    SL- 1291

    NR

    Symptomatic UR: IA- 2

    SL- 1

    Asymptomatic UR: IA-5

    SL- 6

    Symptomatic UR: Overall- 0 maternal deaths, insufficient detail for UR-related perinatal deaths or hysterectomies

    Flamm

    199725

    Evaluate the use of PGE2 for cervical ripening in patients with prior CD

    LTCD and unknown and more than 1 prior

    IA- 453

    SL-4569

    Discretion

    Symptomatic UR: IA- 6

    SL- 33

    Symptomatic UR: Overall- Insufficient detail for UR-related maternal deaths, perinatal deaths, or hysterectomies

    Blanco

    199226

    Determine safety and efficacy of induction with PGE2 in patients with a prior low transever CD

    One prior LTCD

    IA- 25

    SL- 56

    NR

    Symptomatic UR: IA-0

    SL- 0

    Asymptomatic UR: IA- 0

    SL- 0

    NA

    Connolly

    200127

    Identify risk factors for scar dehiscence in labor.

    Cases: 1 prior LTCD or low vertical CD who underwent TOL with dehiscence

    Controls: one prior LTCD or low vertical CD who underwent TOL without dehiscence

    Cases: 13

    Controls: 13

    NR

    8 partial dehiscence

    5 complete dehiscence

    0 maternal deaths, 0 perinatal deaths, 0 hysterectomies

    Leung

    199328

    Identify risk of uterine rupture in a trial of labor after a previous cesarean delivery.

    Cases: patients with prior CD and UR while undergoing subsequent TOL

    Controls: patients with prior CD and subsequent TOL and no UR during same time, randomly selected, grouped by year

    (More than one and unknown allowed)

    Cases: 70

    Controls: 70

    Yes

    Symptomatic UR: 70

    NR

    Leung

    199329

    Identify risk factors associated with overt, catastrophic uterine rupture after previous cesarean delivery.

    Case series of all cases of uterine rupture after a previous cesarean delivery

    99 URs

    NR

    Symptomatic UR: 99

    Symptomatic UR: 1 maternal death, 6 perinatal deaths, 19 hysterectomies, 29 transfusions.

    Bujold

    200230

    Evaluate factors associated with neonatal disease and death caused by uterine rupture in patients undergoing a trial of labor after previous cesarean delivery.

    Case series of symptomatic UR

    following TOL after LTCD

    23 Urs

    NR

    Symptomatic UR: 23

    Symptomatic UR: 1 perinatal death, 3 hypoxicischemic encephalopathies

    Smith

    200211

    Determine risk of intrapartum still birth or neonatal death between trial of labor after previous cesarean delivery and planned repeat cesarean delivery.

    Singleton pregnancies between 37-42 weeks, cephalic, without lethal congenital anomalies, one or more prior CD, not clear what was done with unknown and low vertical

    SL/IA- 15515

    ERCD- 9014

    NR

    NA

    Perinatal Death due to mechanical-TOL- 7

    ERCD- 0

    Mechanical-uterine rupture, cord compression (including prolapse), birth trauma, or asphysixa associated with disproportion.


     

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