Uterine rupture
Research Article
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DOI:
https://doi.org/10.58372/2835-6276.1103Keywords:
Cesarean section, Hysterotomy, Niche, TOLAC, Uterine rupture, VBACAbstract
The increasing rate of elective and indicated caesarean sections worldwide has led to new pathologies and management challenges. The number of patients undergoing trial of labor after caesarean section (TOLAC) is also increasing. Three professional societies provide detailed guidelines based on scientific evidence for the management of patients attempting vaginal birth after caesarean section (VBAC). However, they do not provide any recommendations for the actual surgical steps to be followed to minimize the risks of uterine rupture (UR) during TOLAC. Uterine scar condition, intrapartum management and maternal health status correlate to uterine scar rupture risk and provide guidance for parturient TOLAC eligibility. TOLAC and vaginal delivery success rate as reported by the largest studies is between 60% and 77%. Uterine rupture is more prevalent in VBAC-2 patients (1.59%) in contrast to VBAC-1 (0.72%). Additionally, VBAC-2 patients have higher incidence of caesarean hysterectomy 0.56% vs. 0.19% for VBAC-1. The chances of successful VBAC increase when the interpregnancy/interdelivery interval is less than 6.3 years and less than 24 months, respectively. No difference was detected between the techniques of uterine incision closure of the previous CS and TOLAC results, although closure of the CS uterine incision in 2 layers seems to be practiced more widely. Niche or isthmocele presents another complication of CS. Secondary infertility due to niche, will eventually direct to hysteroscopic or laparoscopic repair, depending on the residual myometrial thickness (RMT) as measured by US scan. When RMT is below 3 mm or 2.5 mm surgery can be performed, to prevent any spontaneous UR in case of pregnancy. Monitoring by US scanning of hysterotomy scar after myomectomy can detect hematoma. In patients with severe postoperative pain but hemodynamically stable follow up by US scan examination can direct the management decision. In those patients with active bleeding and deterioration of hysterotomy scar edema will be an indication to surgery. There is no firm evidence regarding which type of thread, knotting or sequence of suturing is more favorable to reduce the risk of UR after VBAC or hysterotomy after myomectomy.
References
Cunningham F.G., Leveno KJ, Bloom SL et al. Williams Obstetrics 24th Edition. MacGrawHill Education 2016. Obstetrical Hemorrhage pp 790-794.
Gardeil F, Daly S, Turner MJ. Uterine Rupture in pregnancy reviewed. Eur J Obstet Gynecol Reprod Biol. 1994 Aug. 56(2):107-10.
Spong CY, Landon MB, Gilbert S, Rouse DJ, Leveno KJ, Varner MW, et al. Risk of uterine rupture and adverse perinatal outcome at term after cesarean delivery. Obstet Gynecol. 2007;110(4):801-7.
Cahill AG, Stamilio DM, Odibo AO, Peipert JF, Ratcliffe SJ, Stevens EJ, et al. Is vaginal birth after cesarean (VBAC) or elective repeat cesarean safer in women with a prior vaginal delivery? Am J Obstet Gynecol. 2006;195(4):1143-7.
Mozurkewich EL, Hutton EK. Elective repeat cesarean delivery versus trial of labor: a meta-analysis of the literature from 1989 to 1999. Am J Obstet Gynecol. 2000;183(5):1187-97.
Hibbard JU, Ismail MA, Wang Y, Te C, Karrison T, Ismail MA. Failed vaginal birth after a cesarean section: how risky is it? I. Maternal morbidity. Am J Obstet Gynecol. 2001;184(7):1365-71; discussion 71-3.
Bolis G., Manuale di Ginecologia e Ostetricia, Edises II edizione, 2017, pp 750-752.
Zanoio L. ea, Ginecologia e Ostetricia, Edra II edizione, 2013, pp 915-917.
American College of O, Gynecologists. ACOG Practice bulletin no. 115: Vaginal birth after previous cesarean delivery. Obstet Gynecol. 2010;116(2 Pt 1):450-63.
Leung AS, Leung EK, Paul RH. Uterine rupture after previous cesarean delivery: maternal and fetal consequences. Am J Obstet Gynecol. 1993;169(4):945-50.
Bujold E, Gauthier RJ. Neonatal morbidity associated with uterine rupture: what are the risk factors? Am J Obstet Gynecol. 2002;186(2):311-4.
Martel MJ, MacKinnon CJ, Clinical Practice Obstetrics Committee SoO, Gynaecologists of C. Guidelines for vaginal birth after previous Caesarean birth. J Obstet Gynaecol Can. 2005;27(2):164-88.
Il Parto, Manuale di Ostetricia e Giencologia, S. Felis e S. Parmigiani. Edi-Ermes 2016, pp 259-164.
Miller DA, Goodwin TM, Gherman RB, Paul RH. Intrapartum rupture of the unscarred uterus. Obstet Gynecol. 1997;89(5 Pt 1):671-3.
Walsh CA, Baxi LV. Rupture of the primigravid uterus: a review of the literature. Obstet Gynecol Surv. 2007;62(5):327-34; quiz 53-4.
Thisted DL, Mortensen LH, Krebs L. Uterine rupture without previous caesarean delivery: a population-based cohort study. Eur J Obstet Gynecol Reprod Biol. 2015;195:151-5.
Seracchioli R, Manuzzi L, Vianello F, Gualerzi B, Savelli L, Paradisi R, et al. Obstetric and delivery outcome of pregnancies achieved after laparoscopic myomectomy. Fertil Steril. 2006;86(1):159-65.
Gambacorti-Passerini ZM, Penati C, Carli A, Accordino F, Ferrari L, Berghella V, et al. Vaginal birth after prior myomectomy. Eur J Obstet Gynecol Reprod Biol. 2018;231:198-203.
Garber L, Goldberg J. Re: Vaginal birth after prior myomectomy. Eur J Obstet Gynecol Reprod Biol. 2019;241:129.
Royal College of Obstetricians and Gynaecologists. Birth after Previous Caesarean Birth. Green-top Guideline No. 45. 2015. .
Rovio PH, Heinonen PK. Pregnancy outcomes after transvaginal myomectomy by colpotomy. Eur J Obstet Gynecol Reprod Biol. 2012;161(2):130-3.
Parker WH, Einarsson J, Istre O, Dubuisson JB. Risk factors for uterine rupture after laparoscopic myomectomy. J Minim Invasive Gynecol. 2010;17(5):551-4.
Makino S, Tanaka T, Itoh S, Kumakiri J, Takeuchi H, Takeda S. Prospective comparison of delivery outcomes of vaginal births after cesarean section versus laparoscopic myomectomy. J Obstet Gynaecol Res. 2008;34(6):952-6.
Kumakiri J, Takeuchi H, Itoh S, Kitade M, Kikuchi I, Shimanuki H, et al. Prospective evaluation for the feasibility and safety of vaginal birth after laparoscopic myomectomy. J Minim Invasive Gynecol. 2008;15(4):420-4.
Gavai M, Berkes E, Lazar L, Fekete T, Takacs ZF, Urbancsek J, et al. Factors affecting reproductive outcome following abdominal myomectomy. J Assist Reprod Genet. 2007;24(11):525-31.
Kumakiri J, Takeuchi H, Kitade M, Kikuchi I, Shimanuki H, Itoh S, et al. Pregnancy and delivery after laparoscopic myomectomy. J Minim Invasive Gynecol. 2005;12(3):241-6.
Campo S, Campo V, Gambadauro P. Reproductive outcome before and after laparoscopic or abdominal myomectomy for subserous or intramural myomas. Eur J Obstet Gynecol Reprod Biol. 2003;110(2):215-9.
Shokeir T, Abdelshaheed M, El-Shafie M, Sherif L, Badawy A. Determinants of fertility and reproductive success after hysteroscopic septoplasty for women with unexplained primary infertility: a prospective analysis of 88 cases. Eur J Obstet Gynecol Reprod Biol. 2011;155(1):54-7.
Nouri K, Ott J, Huber JC, Fischer EM, Stogbauer L, Tempfer CB. Reproductive outcome after hysteroscopic septoplasty in patients with septate uterus--a retrospective cohort study and systematic review of the literature. Reprod Biol Endocrinol. 2010;8:52.
Landon MB, Hauth JC, Leveno KJ, Spong CY, Leindecker S, Varner MW, et al. Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery. N Engl J Med. 2004;351(25):2581-9.
Macones GA, Peipert J, Nelson DB, Odibo A, Stevens EJ, Stamilio DM, et al. Maternal complications with vaginal birth after cesarean delivery: a multicenter study. Am J Obstet Gynecol. 2005;193(5):1656-62.
Lavin JP, Stephens RJ, Miodovnik M, Barden TP. Vaginal delivery in patients with a prior cesarean section. Obstet Gynecol. 1982;59(2):135-48.
Flamm BL, Newman LA, Thomas SJ, Fallon D, Yoshida MM. Vaginal birth after cesarean delivery: results of a 5-year multicenter collaborative study. Obstet Gynecol. 1990;76(5 Pt 1):750-4.
Miller DA, Diaz FG, Paul RH. Vaginal birth after cesarean: a 10-year experience. Obstet Gynecol. 1994;84(2):255-8.
McMahon MJ, Luther ER, Bowes WA, Jr., Olshan AF. Comparison of a trial of labor with an elective second cesarean section. N Engl J Med. 1996;335(10):689-95.
Martin JN, Jr., Perry KG, Jr., Roberts WE, Meydrech EF. The case for trial of labor in the patient with a prior low-segment vertical cesarean incision. Am J Obstet Gynecol. 1997;177(1):144-8.
Shipp TD, Zelop CM, Repke JT, Cohen A, Caughey AB, Lieberman E. Intrapartum uterine rupture and dehiscence in patients with prior lower uterine segment vertical and transverse incisions. Obstet Gynecol. 1999;94(5 Pt 1):735-40.
Lydon-Rochelle M, Holt VL, Easterling TR, Martin DP. Risk of uterine rupture during labor among women with a prior cesarean delivery. N Engl J Med. 2001;345(1):3-8.
Pruett KM, Kirshon B, Cotton DB, Poindexter AN, 3rd. Is vaginal birth after two or more cesarean sections safe? Obstet Gynecol. 1988;72(2):163-5.
Beall M, Eglinton GS, Clark SL, Phelan JP. Vaginal delivery after cesarean section in women with unknown types of uterine scar. J Reprod Med. 1984;29(1):31-5.
Chapman SJ, Owen J, Hauth JC. One- versus two-layer closure of a low transverse cesarean: the next pregnancy. Obstet Gynecol. 1997;89(1):16-8.
Durnwald C, Mercer B. Uterine rupture, perioperative and perinatal morbidity after single-layer and double-layer closure at cesarean delivery. Am J Obstet Gynecol. 2003;189(4):925-9.
Bujold E, Bujold C, Hamilton EF, Harel F, Gauthier RJ. The impact of a single-layer or double-layer closure on uterine rupture. Am J Obstet Gynecol. 2002;186(6):1326-30.
Huang WH, Nakashima DK, Rumney PJ, Keegan KA, Jr., Chan K. Interdelivery interval and the success of vaginal birth after cesarean delivery. Obstet Gynecol. 2002;99(1):41-4.
Srinivas SK, Stamilio DM, Stevens EJ, Peipert JF, Odibo AO, Macones GA. Safety and success of vaginal birth after cesarean delivery in patients with preeclampsia. Am J Perinatol. 2006;23(3):145-52.
Shipp TD, Zelop CM, Repke JT, Cohen A, Lieberman E. Interdelivery interval and risk of symptomatic uterine rupture. Obstet Gynecol. 2001;97(2):175-7.
Landon MB, Spong CY, Thom E, Hauth JC, Bloom SL, Varner MW, et al. Risk of uterine rupture with a trial of labor in women with multiple and single prior cesarean delivery. Obstet Gynecol. 2006;108(1):12-20.
Trojano G, Damiani GR, Olivieri C, Villa M, Malvasi A, Alfonso R, et al. VBAC: antenatal predictors of success. Acta Biomed. 2019;90(3):300-9.
Mercer BM, Gilbert S, Landon MB, Spong CY, Leveno KJ, Rouse DJ, et al. Labor outcomes with increasing number of prior vaginal births after cesarean delivery. Obstet Gynecol. 2008;111(2 Pt 1):285-91.
Varner MW, Leindecker S, Spong CY, Moawad AH, Hauth JC, Landon MB, et al. The Maternal-Fetal Medicine Unit cesarean registry: trial of labor with a twin gestation. Am J Obstet Gynecol. 2005;193(1):135-40.
Cahill A, Stamilio DM, Pare E, Peipert JP, Stevens EJ, Nelson DB, et al. Vaginal birth after cesarean (VBAC) attempt in twin pregnancies: is it safe? Am J Obstet Gynecol. 2005;193(3 Pt 2):1050-5.
Ford AA, Bateman BT, Simpson LL. Vaginal birth after cesarean delivery in twin gestations: a large, nationwide sample of deliveries. Am J Obstet Gynecol. 2006;195(4):1138-42.
Aaronson D, Harlev A, Sheiner E, Levy A. Trial of labor after cesarean section in twin pregnancies: maternal and neonatal safety. J Matern Fetal Neonatal Med. 2010;23(6):550-4.
Zelop CM, Shipp TD, Cohen A, Repke JT, Lieberman E. Trial of labor after 40 weeks' gestation in women with prior cesarean. Obstet Gynecol. 2001;97(3):391-3.
Flamm BL, Goings JR. Vaginal birth after cesarean section: is suspected fetal macrosomia a contraindication? Obstet Gynecol. 1989;74(5):694-7.
Leung AS, Farmer RM, Leung EK, Medearis AL, Paul RH. Risk factors associated with uterine rupture during trial of labor after cesarean delivery: a case-control study. Am J Obstet Gynecol. 1993;168(5):1358-63.
Elkousy MA, Sammel M, Stevens E, Peipert JF, Macones G. The effect of birth weight on vaginal birth after cesarean delivery success rates. Am J Obstet Gynecol. 2003;188(3):824-30.
Kok N, Wiersma IC, Opmeer BC, de Graaf IM, Mol BW, Pajkrt E. Sonographic measurement of lower uterine segment thickness to predict uterine rupture during a trial of labor in women with previous Cesarean section: a meta-analysis. Ultrasound Obstet Gynecol. 2013;42(2):132-9.
Farmer RM, Kirschbaum T, Potter D, Strong TH, Medearis AL. Uterine rupture during trial of labor after previous cesarean section. Am J Obstet Gynecol. 1991;165(4 Pt 1):996-1001.
Ayres AW, Johnson TR, Hayashi R. Characteristics of fetal heart rate tracings prior to uterine rupture. Int J Gynaecol Obstet. 2001;74(3):235-40.
Ridgeway JJ, Weyrich DL, Benedetti TJ. Fetal heart rate changes associated with uterine rupture. Obstet Gynecol. 2004;103(3):506-12.
Craver Pryor E, Mertz HL, Beaver BW, Koontz G, Martinez-Borges A, Smith JG, et al. Intrapartum predictors of uterine rupture. Am J Perinatol. 2007;24(5):317-21.
Rosen MG, Dickinson JC, Westhoff CL. Vaginal birth after cesarean: a meta-analysis of morbidity and mortality. Obstet Gynecol. 1991;77(3):465-70.
Cahill AG, Waterman BM, Stamilio DM, Odibo AO, Allsworth JE, Evanoff B, 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;199(1):32 e1-5.
Cahill AG, Stamilio DM, Odibo AO, Peipert JF, Stevens EJ, Macones GA. Does a maximum dose of oxytocin affect risk for uterine rupture in candidates for vaginal birth after cesarean delivery? Am J Obstet Gynecol. 2007;197(5):495 e1-5.
Jozwiak M, van de Lest HA, Burger NB, Dijksterhuis MG, De Leeuw JW. Cervical ripening with Foley catheter for induction of labor after cesarean section: a cohort study. Acta Obstet Gynecol Scand. 2014;93(3):296-301.
Schmitz T, Pourcelot AG, Moutafoff C, Biran V, Sibony O, Oury JF. Cervical ripening with low-dose prostaglandins in planned vaginal birth after cesarean. PLoS One. 2013;8(11):e80903.
Haas J, Barzilay E, Chayen B, Lebovitz O, Yinon Y, Mazaki-Tovi S, et al. Safety of low-dose prostaglandin E2 induction in grandmultiparous women with previous cesarean delivery. J Matern Fetal Neonatal Med. 2014;27(5):445-8.
Jozwiak M, Dodd JM. Methods of term labour induction for women with a previous caesarean section. Cochrane Database Syst Rev. 2013(3):CD009792.
Macones GA, Cahill A, Pare E, Stamilio DM, Ratcliffe S, Stevens E, et al. Obstetric outcomes in women with two prior cesarean deliveries: is vaginal birth after cesarean delivery a viable option? Am J Obstet Gynecol. 2005;192(4):1223-8; discussion 8-9.
Tahseen S, Griffiths M. Vaginal birth after two caesarean sections (VBAC-2)-a systematic review with meta-analysis of success rate and adverse outcomes of VBAC-2 versus VBAC-1 and repeat (third) caesarean sections. BJOG. 2010;117(1):5-19.
Ritchie EH. Pregnancy after rupture of the pregnant uterus. A report of 36 pregnancies and a study of cases reported since 1932. J Obstet Gynaecol Br Commonw. 1971;78(7):642-8.
Reyes-Ceja L, Cabrera R, Insfran E, Herrera-Lasso F. Pregnancy following previous uterine rupture. Study of 19 patients. Obstet Gynecol. 1969;34(3):387-9.
Eshkoli T, Weintraub AY, Baron J, Sheiner E. The significance of a uterine rupture in subsequent births. Arch Gynecol Obstet. 2015;292(4):799-803.
Medically indicated late-preterm and early-term deliveries. ACOG Committee Opinion No. 764. American College of Obstetricians and Gynecologists. Obstet Gynecol 2019;133:e151–55. (Level III).
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