Pregnancy Outcomes and Associated Factors for Uterine Rupture: A
population-based retrospective study
Abstract
Objective To assess the incidence of uterine rupture, its association
with previous uterine surgery and vaginal birth after a caesarean
section (VBAC), and the maternal and perinatal implications. Design
Population-based retrospective study. Setting Shanghai, China.
Participants A total of 209,112 deliveries were attended and 41 uterine
rupture cases were included. Methods All pregnant women treated for
ruptured uterus in one center between 2013 and 2020 were included. Their
case folders retrieved from the medical records room were
retrospectively reviewed. Main outcome measure Adverse maternal and
neonatal outcomes. Results The incidence of uterine rupture was 1.96/10
000 births. 16 (39.0%) had maternal and fetal complications. There were
no maternal deaths secondary to uterine rupture, while perinatal
mortality attributable to uterine rupture was 7.32 %. Among all case,
38 (92.68%) were scarred uterus and 3(7.32%) were unscarred uterus.
The most common cause of uterine rupture was previous cesarean section
while cases with a history of laparoscopic myomectomy often had serious
adverse outcome. 24 (59%) of ruptures were anterior lower uterine
segment. Fetal heart rate monitoring changes are the most reliable
presenting clinical symptom in our study. Conclusion Incidence of
uterine rupture in the study area was consistent with developed
countries. Further improvement in obstetric care and strong
collaboration with referring health facilities was needed to ensure
maternal and perinatal safety.