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[Obstetrical outcome and risk of uterine rupture following a caesarean section before 32 weeks]
A-S Maisonneuve1, J-B Haumonte, X Carcopino
1Service de gynécologie obstétrique, CHU Nord, Assistance publique-Hôpitaux de Marseille, université de la Méditerranée, chemin des Bourrely, 13195 Marseille cedex 20, France.
Objective:
Our aim was to evaluate the subsequent obstetrical outcome and rate of uterine rupture following a caesarean section before 32 weeks of gestation.
Patients And Methods:
A retrospective cohort study of 200 consecutive women with a prior caesarean section performed between 25 and 32 weeks were contacted by questionnaire or followed through medical charts to determine the subsequent mode of delivery.
Results:
Two hundred caesarean section were performed between 25 and 32 weeks from January 1997 to March 2000. Thirty-nine patients (19.2%) were lost to follow-up. Seventy-one patients had a subsequent delivery. Thirty-two attempted vaginal birth and the success rate was 87.5%. Thirty-nine patients had a subsequent caesarean. One case of uterine rupture occurred before labour at 31 weeks (1.4%, % IC 95% [0.25; 7.56]).
Conclusion:
After a previous caesarean delivery before 32 weeks, a trial of labour may be proposed when obstetrical conditions are optimal. However, uterine rupture may occur prior to labor.
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