The risk of uterine rupture is not increased with single- compared with double-layer closure: a Swedish cohort study
2015 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 122, no 11, 1535-1541 p.Article in journal (Refereed) Published
To compare single- with double-layer closure of the uterus for the risk of uterine rupture in women attempting vaginal birth after one prior caesarean delivery.
From a total of 19 604 nulliparous women delivered by caesarean section in the years 2001-2007, 7683 women attempting vaginal birth in their second delivery were analysed.
Data from population-based registers were linked to hospital-based registers that held data from maternity and delivery records. Logistic regression was used to estimate the risk of uterine rupture after single- or double-layer closure of the uterus. Results are presented as odds ratios (ORs) with 95% confidence intervals (95% CIs).
MAIN OUTCOME MEASURE:
Uterine rupture during labour occurred in 103 (1.3%) women. There was no increased risk of uterine rupture when single- was compared with double-layer closure of the uterus (OR 1.17; 95% CI 0.78-1.76). Maternal factors associated with uterine rupture were: age ≥35 years and height ≤160 cm. Factors from the first delivery associated with uterine rupture in a subsequent delivery were: infection and giving birth to an infant large for gestational age. Risk factors from the second delivery were induction of labour, use of epidural analgesia, and a birthweight of ≥4500 g.
There was no significant difference in the rate of uterine rupture when single-layer closure was compared with double -layer closure of the uterus.
Place, publisher, year, edition, pages
2015. Vol. 122, no 11, 1535-1541 p.
Obstetrics, Gynecology and Reproductive Medicine
IdentifiersURN: urn:nbn:se:uu:diva-232789DOI: 10.1111/1471-0528.13015ISI: 000362752100020PubMedID: 25088680OAI: oai:DiVA.org:uu-232789DiVA: diva2:749760
FunderSwedish Research CouncilSwedish Society of Medicine