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Silent Danger: Risk Factors and Outcomes of Fortuitously Discovered Uterine Rupture - A 41-Case Cohort Study
Narjes Karmous1,2, Siwar Ghrab1, Abdelwahab Masmoudi1
1Department B of Obstetrics and Gynecology, Charles Nicolle Hospital, Tinis, Tunisia.
F1000Research
|September 2, 2025
Summary
Silent uterine rupture (UR) is a significant cause of maternal morbidity. Prolonged labor and lower maternal weight are key predictors of complete UR, aiding in early risk identification.
Area of Science:
- Obstetrics and Gynecology
- Maternal Health
- Clinical Risk Assessment
Background:
- Uterine rupture (UR) is a major cause of maternal morbidity, particularly in low-resource settings.
- Clinically silent cases of UR are often discovered incidentally, highlighting a gap in risk assessment.
- In Tunisia, UR affects 1.5% of pregnancies, predominantly scar-related.
Purpose of the Study:
- To identify factors associated with the development of fortuitously discovered uterine rupture.
- To compare clinical profiles and assess maternal/neonatal outcomes in asymptomatic UR cases.
- To analyze risk factors for complete versus incomplete uterine rupture.
Main Methods:
- Retrospective, longitudinal cohort study from January 2014 to December 2024.
- Analysis of 41 asymptomatic uterine rupture cases (complete/incomplete).
- Comparison of clinical, sociodemographic, and outcome data between UR subgroups.
Main Results:
- Prolonged labor (>220 minutes) significantly increased the odds of complete UR (OR=45.231).
- Lower maternal weight (<68 kg) was associated with reduced odds of incomplete UR (OR=0.033).
- Incomplete UR cases showed longer gestational age and labor duration compared to complete UR.
Conclusions:
- Uterine rupture presents a broader clinical spectrum than previously recognized.
- Prolonged labor and maternal weight are significant predictors for targeted surveillance.
- Early identification of these risk factors can improve management of high-risk pregnancies.
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