Uterine rupture after previous cesarean delivery: maternal and fetal consequences

Abstract

Objective: The purpose of this study was to identify the risk factors associated with overt, catastrophic uterine rupture and to report maternal and neonatal outcomes. The associated elapsed time window for delivery of an uncompromised neonate was also investigated.

Study design: A retrospective study with review of charts and monitor strips was performed.

Results: Between Jan. 1, 1983, and June 30, 1992, there were 106 cases of uterine rupture at our institution. Of these, seven charts were incomplete and excluded; of the remainder, 28 patients had complete, 13 patients had partial, and 58 patients had no fetal extrusion into the maternal abdomen. Maternal characteristics or intrapartum events were not predictive of the catastrophic extent of uterine rupture. There was one maternal death. Complete fetal extrusion was associated with a higher incidence of perinatal mortality and morbidity. Significant neonatal morbidity occurred when > or = 18 minutes elapsed between the onset of prolonged deceleration and delivery.

Conclusion: Neonatal and maternal complications in uterine rupture with complete fetal extrusion were low with prompt intervention.