ResearchObstetricsAssociation of induction of labor and uterine rupture in women attempting vaginal birth after cesarean: a survival analysis
Section snippets
Materials and Methods
This is a nested case-control study conducted from 1996 through 2000 within a 17-center retrospective cohort study of pregnant women with at least 1 previous cesarean delivery. To identify factors associated with uterine rupture, all cases (women who attempted TOLAC and experienced uterine rupture) were matched on hospital site with 5 control subjects, chosen by a random number generator, who attempted TOLAC but did not have a uterine rupture. Institutional review board approval was obtained
Results
Within the retrospective cohort of 25,005 patients with a history of at least 1 prior cesarean delivery, 13,706 attempted TOLAC, and of those who attempted TOLAC, 134 experienced a uterine rupture (cases). At random, 670 of the 13,572 patients who attempted TOLAC but did not experience a uterine rupture were selected as controls. For this analysis of patients with only 1 prior cesarean, 111 cases and 612 controls were included. Cases and controls were similar with respect to maternal age,
Comment
When considering labor duration, we determined that women with 1 prior LTCS who undergo induction of labor are at similar risk of uterine rupture compared to women who present in spontaneous labor. When oxytocin exposure is considered, induction of labor and augmentation of labor have similar risks of uterine rupture, although both induction and augmentation of labor are associated with increased risk of uterine rupture compared to women who labor spontaneously. The initial cervical exam
References (17)
- et al.
Maternal complications with vaginal birth after cesarean delivery: a multicenter study
Am J Obstet Gynecol
(2005) - et al.
Uterine rupture during induced or augmented labor in gravid women with one prior cesarean delivery
Am J Obstet Gynecol
(1999) - et al.
Uterine rupture associated with the use of misoprostol in the gravid patient with a previous cesarean section
Am J Obstet Gynecol
(1999) - et al.
Oxytocin dose and the risk of uterine rupture in trial of labor after cesarean
Obstet Gynecol
(2001) - et al.
Does a maximum dose of oxytocin affect risk for uterine rupture in candidates for vaginal birth after cesarean delivery?
Am J Obstet Gynecol
(2007) - et al.
Higher maximum doses of oxytocin are associated with an unacceptably high risk for uterine rupture in patients attempting vaginal birth after cesarean delivery
Am J Obstet Gynecol
(2008) - et al.
Lack of utility of standard labor curves in the prediction of progression during labor induction
Am J Obstet Gynecol
(2000) - et al.
Risk factors for uterine rupture during a vaginal birth after one previous cesarean section: a case-control study
Eur J Obstet Gynecol Reprod Biol
(2010)
Cited by (40)
Risk of uterine rupture in vaginal birth after cesarean: Systematic review
2017, Enfermeria ClinicaWhat We Have Learned About Trial of Labor After Cesarean Delivery from the Maternal-Fetal Medicine Units Cesarean Registry
2016, Seminars in PerinatologyCitation Excerpt :A secondary analysis from our study of the 11,187 women with one prior cesarean undergoing induction showed an increased risk of uterine rupture in women with no prior vaginal delivery, but no such a risk in women who had a history of prior vaginal delivery.13 In this analysis, the need for cervical ripening, which has been suggested to be a factor in other studies, did not affect the frequency of uterine rupture.14 Based on these cumulative data, ACOG continues to consider induction of labor for maternal or fetal indications to be an option for women undergoing TOLAC.
Vaginal Birth After Cesarean Delivery
2016, Obstetrics: Normal and Problem PregnanciesFailed induction of labor
2015, Seminars in PerinatologyCitation Excerpt :Once 6 cm cervical dilation is reached and the active phase is entered, labor progress during induction of labor is similar to the patient in spontaneous labor; however, the duration of the phase before 6 cm dilation is longer in women undergoing induction of labor.20 More than half of induced women remained in the latent phase for 6 h, and nearly one-fifth remain in the latent phase for 12 h or longer.21 Also, women who are induced after cervical ripening have a markedly prolonged labor progression from 3 to 4 cm.
This work was supported by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (R01HD35631, G.A.M.). L.M.H. is supported by a grant from NICHD (T32HD055172; principal investigator, G.A.M.) and National Institutes of Health/National Center for Research Resources (UL1RR024992; principal investigator, Bradley Evanoff, MD, MPH).
The authors report no conflict of interest.
Reprints not available from the authors.
Cite this article as: Harper LM, Cahill AG, Boslaugh S, et al. Association of induction of labor and uterine rupture in women attempting vaginal birth after cesarean: a survival analysis. Am J Obstet Gynecol 2012;206:51.e1-5.