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Contemporary analysis of maternal and neonatal morbidity after uterine rupture: A nationwide population‐based study
Author(s) -
Vilchez Gustavo,
Dai Jing,
Kumar Komal,
Lagos Moraima,
Sokol Robert J.
Publication year - 2017
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13300
Subject(s) - medicine , uterine rupture , neonatal intensive care unit , obstetrics , odds ratio , logistic regression , hysterectomy , intensive care unit , population , complication , blood transfusion , pediatrics , gynecology , uterus , intensive care medicine , surgery , environmental health
Abstract Aim Uterine rupture is a rare but feared perinatal event. Despite abundant research and changes to guidelines implemented to reduce this complication, evaluation of whether uterine rupture still engenders significant maternal/neonatal morbidity has not been conducted. We analyzed recent cases of maternal/neonatal morbidity after uterine rupture. Methods Deliveries complicated by uterine rupture from 2011 to 2012 in the United States were selected. Comparison cases without uterine rupture were used as controls. Measures of maternal/neonatal complications were compared with χ 2 test, and relative risks were calculated. Logistic regression was used to identify the most significant complications. P < 0.05 indicated statistical significance. Results From 7 922 016 births, 1925 cases of uterine rupture and 3765 controls were identified. Regression models retained four maternal outcomes; blood transfusion was the most common (~15%) and unplanned hysterectomy had the highest odds (~97‐fold). For newborns, the model retained three measures of morbidity; neonatal intensive care unit admission was the most common (~35%) and seizures had the highest odds (~20‐fold). Conclusions Despite efforts to reduce complications, mothers remain at significant risk of unplanned hysterectomy and intensive care unit admission. Neonates are at sizeable risk for neonatal intensive care unit admission and seizures, recognized markers of long‐term neurobehavioral abnormality. Uterine rupture remains a major risk for mothers and babies.