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Am J Perinatol 2007; 24(5): 317-321
DOI: 10.1055/s-2007-981433
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Intrapartum Predictors of Uterine Rupture

Elizabeth Craver Pryor1 , Heather L. Mertz1 , Brittian W. Beaver1 , Gretchen Koontz1 , Anibal Martinez-Borges1 , Jennifer G. Smith1 , David Merrill1
  • 1Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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Publikationsdatum:
21. Mai 2007 (online)

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ABSTRACT

This case-controlled study reviewed 26 cases of uterine rupture at an academic medical center. Controls were selected in a 2:1 design by reviewing the immediate successful vaginal birth after cesarean delivery (VBAC) before and after each case of uterine rupture. At less than 2 hours before delivery or acute uterine rupture, mild and severe variable decelerations, persistent abdominal pain, and hyperstimulation were more common in cases of uterine rupture as compared to controls and had statistically significant positive likelihood ratios (LR). Mild and severe variable fetal heart rate decelerations, especially in the presence of persistent abdominal pain, may predict uterine rupture in patients attempting VBAC.

KEYWORDS

VBAC - uterine rupture - mild variable decelerations - severe variable decelerations - persistent abdominal pain - hyperstimulation

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Heather L MertzM.D. 

Wake Forest University School of Medicine, Department of Obstetrics & Gynecology

Medical Center Boulevard, Winston-Salem, NC 27157