Uterus rupture rare after prior cesarean delivery

NEW YORK (Reuters Health) - Pregnant women who have had a prior cesarean delivery appear to have a low risk of rupture of the uterus and other grave pregnancy complications, regardless of the type of delivery, according to a report in the journal Obstetrics and Gynecology.

The findings are based on a study of nearly 40,000 full-term women who all had a prior cesarean delivery and were evaluated over 4 years at 19 centers.

The overall risk of uterus rupture was 0.32 percent. The risk of stillbirth, newborn death, or other adverse outcome of the fetus or infant was 0.27 percent, lead author Dr. Catherine Y. Spong, from the National Institutes of Health in Bethesda, Maryland, and colleagues report. The rupture risks for repeat cesarean section ranged from 0.02 to 0.12 percent.

Among women who delivered by repeat c-section, the presence of labor was associated with a higher rate of rupture than delivery without labor.

Women who underwent a trial of labor had the highest rate of rupture: 0.74 percent.

"These data provide physicians and women with pragmatic information for counseling on the risks of uterine rupture," the authors conclude, as well as adverse outcomes for the infant and the full-term mother who has a history of previous cesarean delivery, the authors conclude.

SOURCE: Obstetrics Gynecology, October 2007.