open access

Vol 91, No 2 (2020)
Research paper
Published online: 2020-02-10
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Unscarred uterine rupture and subsequent pregnancy outcome — a tertiary centre experience

Nurullah Peker1, Edip Aydın2, Mehmet Sıddık Evsen1, Fatma Nur Hançer2, Muhammet Hanifi Bademkıran2, Serhat Ege2, Bekir Kahveci2, Talip Karaçor3, Talip Gül1
·
Pubmed: 32083306
·
Ginekol Pol 2020;91(2):95-90.
Affiliations
  1. Department of Obstetrics and Gynecology, Dicle University, Faculty of Medicine, Diyarbakır, Türkiye
  2. Department of Obstetrics and Gynecology, Health Sciences University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey, Türkiye
  3. Department of Obstetrics and Gynecology, Adıyaman University, Faculty of Medicine, Adıyaman, Türkiye

open access

Vol 91, No 2 (2020)
ORIGINAL PAPERS Obstetrics
Published online: 2020-02-10

Abstract

Objectives: The aim of this study was to investigate the incidence, etiology and obstetric outcomes of rupture in unscarred
uterine rupture and in those with a history of uterine rupture
Material and methods: The hospital records of women who had delivered between May 2005 and May 2017 at a tertiary
center were examined retrospectively. Data on patients with unscarred uterine rupture in pregnancy who had undergone
fertility-preserving surgery were evaluated.
Results: During the study period, 185,609 deliveries occurred. Of those, unscarred uterine rupture has occurred in
67 women. There were no ruptures reported in nulliparous women. The rupture was observed in the isthmic region in
60 (89.6%) patients and in the fundus in 7 (10.4%) patients. Thirty-eight (56.7%) patients had undergone a total or subtotal
hysterectomy, and 29 (43.3%) patients had received primary repair. Ten patients had reconceived after the repair. Of these,
eight patients who had a history of isthmic rupture, successfully delivered by elective C-section at 36–37 wk. of gestation,
and two experienced recurrent rupture at 33 and 34 wk. of gestation, respectively. Both patients had a history of fundal
rupture, and their inter-pregnancy interval was 9 and 11 mo., respectively.
Conclusions: The incidence of rupture in unscarred pregnant uteri was found to be one per 2,770 deliveries. Owing to the
high morbidity, regarding more than half of the cases with rupture eventuated in hysterectomy, clinicians should be prudent
in induction of labour for multiparous women since it was the main cause of rupture in this series. Short inter-pregnancy
intervals and history of fundal rupture may confer a risk for rupture recurrence. Those risk factors for recurrence should be
validated in another studies.

Abstract

Objectives: The aim of this study was to investigate the incidence, etiology and obstetric outcomes of rupture in unscarred
uterine rupture and in those with a history of uterine rupture
Material and methods: The hospital records of women who had delivered between May 2005 and May 2017 at a tertiary
center were examined retrospectively. Data on patients with unscarred uterine rupture in pregnancy who had undergone
fertility-preserving surgery were evaluated.
Results: During the study period, 185,609 deliveries occurred. Of those, unscarred uterine rupture has occurred in
67 women. There were no ruptures reported in nulliparous women. The rupture was observed in the isthmic region in
60 (89.6%) patients and in the fundus in 7 (10.4%) patients. Thirty-eight (56.7%) patients had undergone a total or subtotal
hysterectomy, and 29 (43.3%) patients had received primary repair. Ten patients had reconceived after the repair. Of these,
eight patients who had a history of isthmic rupture, successfully delivered by elective C-section at 36–37 wk. of gestation,
and two experienced recurrent rupture at 33 and 34 wk. of gestation, respectively. Both patients had a history of fundal
rupture, and their inter-pregnancy interval was 9 and 11 mo., respectively.
Conclusions: The incidence of rupture in unscarred pregnant uteri was found to be one per 2,770 deliveries. Owing to the
high morbidity, regarding more than half of the cases with rupture eventuated in hysterectomy, clinicians should be prudent
in induction of labour for multiparous women since it was the main cause of rupture in this series. Short inter-pregnancy
intervals and history of fundal rupture may confer a risk for rupture recurrence. Those risk factors for recurrence should be
validated in another studies.

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Keywords

unscarred uterine rupture; recurrent uterine rupture; uterine repair; timing of delivery; pregnancy outcome

About this article
Title

Unscarred uterine rupture and subsequent pregnancy outcome — a tertiary centre experience

Journal

Ginekologia Polska

Issue

Vol 91, No 2 (2020)

Article type

Research paper

Pages

95-90

Published online

2020-02-10

Page views

2566

Article views/downloads

1617

DOI

10.5603/GP.a2020.0012

Pubmed

32083306

Bibliographic record

Ginekol Pol 2020;91(2):95-90.

Keywords

unscarred uterine rupture
recurrent uterine rupture
uterine repair
timing of delivery
pregnancy outcome

Authors

Nurullah Peker
Edip Aydın
Mehmet Sıddık Evsen
Fatma Nur Hançer
Muhammet Hanifi Bademkıran
Serhat Ege
Bekir Kahveci
Talip Karaçor
Talip Gül

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