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Uterine rupture during pregnancy: The URIDA (uterine rupture international data acquisition) study

2021; Elsevier BV; Volume: 157; Issue: 1 Linguagem: Inglês

10.1002/ijgo.13810

1879-3479

Andrea Tinelli, Ioannis Kosmas, Jose Carugno, Howard Carp, Antonio Malvası, Shlomo B. Cohen, Antonio Simone Laganà, Marta Angelini, Paolo Casadio, Jenifer Chayo, Ettore Cicinelli, Sandro Gerli, Josè Palacios Jaraquemada, Giulia Magnarelli, Mykhailo Medvediev, José Metello, Luigi Nappi, Jude Ehiabhi Okohue, Radmila Sparić, Radomir Stefanović, Avinoam Tzabari, Antonella Vimercati,

Maternal and Perinatal Health Interventions

Abstract Objective To describe the characteristics and peripartum outcomes of patients diagnosed with uterine rupture (UR) by an observational cohort retrospective study on 270 patients. Methods Demographic information, surgical history, symptoms, and postoperative outcome of women and neonates after UR were collected in a large database. The statistical analysis searched for correlation between UR, previous uterine interventions, fibroids, and the successive perinatal outcomes in women with previous UR. Results Uterine rupture was significantly associated with previous uterine surgery, occurring, on average, at 36 weeks of pregnancy in women also without previous uterine surgery. UR did not rise exponentially with an increasing number of uterine operations. Fibroids were related to UR. The earliest UR occurred at 159 days after hysteroscopic myomectomy, followed by laparoscopic myomectomy (251 days) and laparotomic myomectomy (253 days). Fertility preservation was feasible in several women. Gestational age and birth weight seemed not to be affected in the subsequent pregnancy. Conclusion Data analysis showed that previous laparoscopic and abdominal myomectomies were associated with UR in pregnancy, and hysteroscopic myomectomy was associated at earlier gestational ages. UR did not increase exponentially with an increasing number of previous scars. UR should not be considered a contraindication to future pregnancies.