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- Title
Cesarean Delivery Complicated by Peripartum Infection and Risk of Uterine Rupture During Subsequent Trial of Labor.
- Authors
Tamir Yaniv, Rina; Farladansky-Gershnabel, Sivan; Gluska, Hadar; Daykan, Yair; Shechter Maor, Gil; Schonman, Ron; Biron-Shental, Tal
- Abstract
Background: Uterine rupture is a rare, but dangerous obstetric complication that can occur during trial of vaginal birth. Methods: The aim of this study was to evaluate the relationship between peripartum infection at the first caesarean delivery to uterine dehiscence or rupture at the subsequent delivery. We conducted a retrospective case-control study from March 2014 to October 2020 at a single academic medical center. The study group included women with a prior caesarean delivery and proven dehiscence or uterine rupture diagnosed during their subsequent delivery. The control group included women who went through a successful vaginal birth after cesarean section (VBAC) without evidence of dehiscence or uterine rupture. We compared the rate of peripartum infection during the first cesarean delivery (CD) and other relevant variables, between the two groups. Results: A total of 168 women were included, 71 with uterine rupture or dehiscence and 97 with successful VBAC as the control group. The rate of peripartum infection at the first caesarean delivery was significantly higher in the study group compared to the control group (22.2% vs. 8.2%, p = 0.013). Multivariate logistic regression analysis found that peripartum infection remained an independent risk factor for uterine rupture at the subsequent trial of labor after CD (95% confidence interval, p = 0.034). Conclusion: Peripartum infection in the first caesarean delivery, may be an independent risk-factor for uterine rupture in a subsequent delivery.
- Subjects
CESAREAN section; COMMUNICABLE diseases; RISK assessment; ENDOMETRIAL diseases; SURGICAL wound dehiscence; ACADEMIC medical centers; MATERNAL age; MULTIPLE regression analysis; FISHER exact test; LOGISTIC regression analysis; LABOR (Obstetrics); RETROSPECTIVE studies; DESCRIPTIVE statistics; SCARS; MANN Whitney U Test; CHI-squared test; VAGINAL birth after cesarean; ODDS ratio; UTERINE rupture; CASE-control method; FETAL diseases; STATISTICS; PARITY (Obstetrics); PREGNANCY complications; SURGICAL site infections; COMPARATIVE studies; CONFIDENCE intervals; DATA analysis software; PERINATAL period; DISEASE risk factors
- Publication
Journal of Women's Health (15409996), 2024, Vol 33, Issue 7, p986
- ISSN
1540-9996
- Publication type
Article
- DOI
10.1089/jwh.2023.0727