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The International Network of Obstetric Survey Systems study of uterine rupture : a descriptive multi-country population-based study

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Abstract
Objective: International comparison of complete uterine rupture. Design Descriptive multi-country population-based study. Setting: International. Population: International Network of Obstetric Survey Systems (INOSS). Methods: We merged individual data, collected prospectively in nine population-based studies, of women with complete uterine rupture, defined as complete disruption of the uterine muscle and the uterine serosa, regardless of symptoms and rupture of fetal membranes. Main outcome measures: Prevalence of complete uterine rupture, regional variation and correlation with rates of caesarean section (CS) and trial of labour after CS (TOLAC). Severe maternal and perinatal morbidity and mortality. Results: We identified 864 complete uterine ruptures in 2 625 017 deliveries. Overall prevalence was 3.3 (95% CI 3.1-3.5) per 10 000 deliveries, 22 (95% CI 21-24) in women with and 0.6 (95% CI 0.5-0.7) in women without previous CS. Prevalence in women with previous CS was negatively correlated with previous CS rate (rho = -0.917) and positively correlated with TOLAC rate of the background population (rho = 0.600). Uterine rupture resulted in peripartum hysterectomy in 87 of 864 women (10%, 95% CI 8-12%) and in a perinatal death in 116 of 874 infants (13.3%, 95% CI 11.2-15.7) whose mother had uterine rupture. Overall rate of neonatal asphyxia was 28% in neonates who survived. Conclusions: Higher prevalence of complete uterine ruptures per TOLAC was observed in countries with low previous CS and high TOLAC rates. Rates of hysterectomy and perinatal death are about 10% following complete uterine rupture, but in women undergoing TOLAC the rates are extremely low (only 2.2 and 3.2 per 10 000 TOLACs, respectively.) Tweetable abstract: Prevalence of complete uterine rupture is higher in countries with low previous CS and high TOLAC rates.
Keywords
Caesarean section, population-based, severe maternal morbidity, trial of labour after caesarean section, uterine rupture, ATTEMPTED VAGINAL BIRTH, PREVIOUS CESAREAN DELIVERY, MORBIDITY, SECTION, WOMEN, LABOR, RISK, COMPLICATIONS, SURVEILLANCE, NETHERLANDS

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MLA
Vandenberghe, Griet et al. “The International Network of Obstetric Survey Systems Study of Uterine Rupture : a Descriptive Multi-country Population-based Study.” BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY 126.3 (2019): 370–381. Print.
APA
Vandenberghe, G., Bloemenkamp, K., Berlage, S., Colmorn, L., Deneux-Tharaux, C., Gissler, M., Knight, M., et al. (2019). The International Network of Obstetric Survey Systems study of uterine rupture : a descriptive multi-country population-based study. BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 126(3), 370–381.
Chicago author-date
Vandenberghe, Griet, K Bloemenkamp, S Berlage, L Colmorn, C Deneux-Tharaux, M Gissler, M Knight, et al. 2019. “The International Network of Obstetric Survey Systems Study of Uterine Rupture : a Descriptive Multi-country Population-based Study.” Bjog-an International Journal of Obstetrics and Gynaecology 126 (3): 370–381.
Chicago author-date (all authors)
Vandenberghe, Griet, K Bloemenkamp, S Berlage, L Colmorn, C Deneux-Tharaux, M Gissler, M Knight, J Langhoff-Roos, PG Lindqvist, W Oberaigner, J Van Roosmalen, J Zwart, and Kristien Roelens. 2019. “The International Network of Obstetric Survey Systems Study of Uterine Rupture : a Descriptive Multi-country Population-based Study.” Bjog-an International Journal of Obstetrics and Gynaecology 126 (3): 370–381.
Vancouver
1.
Vandenberghe G, Bloemenkamp K, Berlage S, Colmorn L, Deneux-Tharaux C, Gissler M, et al. The International Network of Obstetric Survey Systems study of uterine rupture : a descriptive multi-country population-based study. BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY. 2019;126(3):370–81.
IEEE
[1]
G. Vandenberghe et al., “The International Network of Obstetric Survey Systems study of uterine rupture : a descriptive multi-country population-based study,” BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, vol. 126, no. 3, pp. 370–381, 2019.
@article{8566505,
  abstract     = {Objective: International comparison of complete uterine rupture. Design Descriptive multi-country population-based study.
Setting: International.
Population: International Network of Obstetric Survey Systems (INOSS).
Methods: We merged individual data, collected prospectively in nine population-based studies, of women with complete uterine rupture, defined as complete disruption of the uterine muscle and the uterine serosa, regardless of symptoms and rupture of fetal membranes.
Main outcome measures: Prevalence of complete uterine rupture, regional variation and correlation with rates of caesarean section (CS) and trial of labour after CS (TOLAC). Severe maternal and perinatal morbidity and mortality.
Results: We identified 864 complete uterine ruptures in 2 625 017 deliveries. Overall prevalence was 3.3 (95% CI 3.1-3.5) per 10 000 deliveries, 22 (95% CI 21-24) in women with and 0.6 (95% CI 0.5-0.7) in women without previous CS. Prevalence in women with previous CS was negatively correlated with previous CS rate (rho = -0.917) and positively correlated with TOLAC rate of the background population (rho = 0.600). Uterine rupture resulted in peripartum hysterectomy in 87 of 864 women (10%, 95% CI 8-12%) and in a perinatal death in 116 of 874 infants (13.3%, 95% CI 11.2-15.7) whose mother had uterine rupture. Overall rate of neonatal asphyxia was 28% in neonates who survived.
Conclusions: Higher prevalence of complete uterine ruptures per TOLAC was observed in countries with low previous CS and high TOLAC rates. Rates of hysterectomy and perinatal death are about 10% following complete uterine rupture, but in women undergoing TOLAC the rates are extremely low (only 2.2 and 3.2 per 10 000 TOLACs, respectively.)
Tweetable abstract: Prevalence of complete uterine rupture is higher in countries with low previous CS and high TOLAC rates.},
  author       = {Vandenberghe, Griet and Bloemenkamp, K and Berlage, S and Colmorn, L and Deneux-Tharaux, C and Gissler, M and Knight, M and Langhoff-Roos, J and Lindqvist, PG and Oberaigner, W and Van Roosmalen, J and Zwart, J and Roelens, Kristien},
  issn         = {1470-0328},
  journal      = {BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY},
  keywords     = {Caesarean section,population-based,severe maternal morbidity,trial of labour after caesarean section,uterine rupture,ATTEMPTED VAGINAL BIRTH,PREVIOUS CESAREAN DELIVERY,MORBIDITY,SECTION,WOMEN,LABOR,RISK,COMPLICATIONS,SURVEILLANCE,NETHERLANDS},
  language     = {eng},
  number       = {3},
  pages        = {370--381},
  title        = {The International Network of Obstetric Survey Systems study of uterine rupture : a descriptive multi-country population-based study},
  url          = {http://dx.doi.org/10.1111/1471-0528.15271},
  volume       = {126},
  year         = {2019},
}

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