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Uterine rupture and its complications in the Netherlands: a prospective study
Anneke Kwee1, Michiel L Bots, Gerard H A Visser
1University Medical Centre Utrecht, Department of Obstetrics and Gynaecology, Utrecht, The Netherlands. a.kwee@azu.nl
Objective:
To determine maternal and perinatal morbidity and mortality after uterine rupture in the Netherlands.
Study Design:
All 100 Dutch obstetric departments were asked to participate in a prospective nationwide registration of uterine rupture between 1st April 2002 and 1st April 2003. For every case, a questionnaire about obstetrical history, current pregnancy and delivery, maternal and neonatal outcome was completed.
Results:
Eighty-nine percent of all hospitals in the Netherlands participated. Ninety-eight uterine ruptures were registered; 95 after a previous caesarean section (CS) of which 91 occurred during a trial of labour. The fetus was extruded in the abdominal cavity completely in 18 cases and partially in 13 cases. Major complications due to uterine rupture were: perinatal death (n=11, from 94 cases with a viable fetus, 11.7%) and hysterectomy (n=4, 4.1%).
Conclusion:
These severe complications, perinatal death and hysterectomy, have to be an issue when counselling women on an elective CS and women with a history of a CS on the route of delivery.
