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Updated: Apr 15, 2026

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Uterine rupture: trends over 40 years.

I Al-Zirqi1,2, B Stray-Pedersen2,3, L Forsén1,4

  • 1Norwegian National Advisory Unit on Women's Health, Oslo, Norway.

BJOG : an International Journal of Obstetrics and Gynaecology
|April 8, 2015
PubMed
Summary

Uterine rupture incidence sharply increased in Norway over 40 years, with obstetric interventions like oxytocin and prostaglandins contributing. While severe outcomes decreased, the rise in uterine ruptures warrants further investigation.

Keywords:
Outcomerisk factorstrendsuterine rupture

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Area of Science:

  • Obstetrics and Gynecology
  • Reproductive Health
  • Maternal-Fetal Medicine

Background:

  • Uterine rupture is a rare but serious obstetric emergency.
  • Understanding trends in uterine rupture is crucial for improving maternal safety.
  • Previous studies have shown varying incidence rates globally.

Purpose of the Study:

  • To analyze trends in uterine rupture incidence and outcomes over a 40-year period in Norway.
  • To identify factors contributing to changes in uterine rupture rates.
  • To assess the impact of uterine rupture on maternal and infant outcomes over time.

Main Methods:

  • Population-based study utilizing Norwegian health registries and medical records.
  • Analysis of 1,441,712 maternities from 1967 to 2008.
  • Comparison of uterine rupture incidence and outcomes across four distinct decades using multivariable logistic regression.

Main Results:

  • A significant increase in uterine rupture incidence was observed, rising from 0.9 per 10,000 maternities in 1978-1988 to 6.1 in 2000-2008.
  • Increased rates of labor augmentation with oxytocin, previous cesarean sections, and prostaglandin induction were associated with the rise.
  • Despite the increasing incidence, severe outcomes such as postpartum hemorrhage, hysterectomy, and fetal/infant deaths decreased significantly over the study period.

Conclusions:

  • Norway has experienced a sharp increase in uterine rupture rates in recent decades.
  • Obstetric interventions play a role in this trend but do not fully explain the increase.
  • Continued monitoring and research are necessary to address the rising incidence of uterine rupture.