Takeaway
- Timing of diagnosis of uterine rupture affects maternal morbidity, and classic signs of the condition are not always detected, delaying diagnosis.
Why this matters
- Uterine rupture occurs most commonly during labor.
- It should be suspected if operative vaginal delivery is performed and there are signs of hemorrhage, hypotension, or pain.
Key results
- Rate of uterine rupture was 0.08%.
- 79.7% were diagnosed intrapartum and 20.3% delayed diagnosis.
- Intrapartum diagnosis:
- Most diagnosed in latent phase (63.2%).
- Median time from delivery to diagnosis was 4.5 hours.
- Delayed diagnosis more likely with:
- Older and multiparous women.
- Unscarred uterus (P<.001>
- Induction (P<.001>
- Epidural (P<.001>
- Operative vaginal delivery because of concern over fetal heart tones.
Study design
- Retrospective cohort study.
- Women with a singleton pregnancy diagnosed with uterine rupture between 2005 and 2018 were included (N=143).
- Women were stratified into 1 of 2 groups: diagnosis made intrapartum/intraoperatively (n=114) and diagnosis after vaginal delivery (n=29).
- Funding: None disclosed.
Limitations
- Timing of uterine rupture in the 2 groups was different and could have affected overall outcomes.
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