Previous preterm cesarean delivery: Identification of a new risk factor for uterine rupture in VBAC candidates

Burton Rochelson, Michelle Pagano, Laurie Conetta, Benjamin Goldman, Nidhi Vohra, Michael Frey, Catherine Day

Research output: Contribution to journalReview article

26 Scopus citations

Abstract

Objective. A major risk of trials of labor in patients with prior cesarean delivery is uterine rupture. We evaluated the question of whether a previous cesarean delivery at an early gestational age predisposes the patient to subsequent uterine rupture. Methods. This was a retrospective chart review of patients delivering at North Shore University Hospital with a trial of labor after previous cesarean delivery to ascertain all cases of uterine rupture. Patients who had had a previous cesarean delivery at our institution who did not suffer uterine rupture during a trial of labor served as controls. Results. Twenty-five patients suffered a uterine rupture. The incidence of prior preterm cesarean delivery (PPCD) in this group was 40%, compared to 10.9% of 691 laboring vaginal birth after cesarean (VBAC) patients without rupture (p < 0.001). Patients in the rupture group with a PPCD were less likely to have experienced labor in the index pregnancy and more likely to have had an interdelivery interval of less than two years. Conclusions. An undeveloped lower segment in the preterm uterus represents a risk for later rupture, even if the incision is transverse.

Original languageEnglish (US)
Pages (from-to)339-342
Number of pages4
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume18
Issue number5
DOIs
StatePublished - Nov 1 2005

Keywords

  • Preterm
  • Uterine rupture
  • VBAC

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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