[ozmidwifery] VBAC multi-centred study

[Dean & Jo]

Is there anyone in ozmid land who has the full study:   Vaginal birth after Caesarean section: an Australian multicentre study. VBAC Study Group. Appleton B, Targett C, Rasmussen M, Readman E, Sale F, Permezel M. I am tring to determine exactly what ruptures the researchers refer to... the abstract reads:   Retrospective analysis of medical records and individual case review was undertaken at 11 major obstetric hospitals for a 5 year period from July 1992 to June 1997 to investigate rates of vaginal birth after Caesarean section (VBAC), the occurrences of uterine rupture, and the outcomes for mother and infant following rupture. Total deliveries were 234,015, of which 21,452 or 9.2% were associated with one or more previous Caesarean sections. Within this scar group, 5419 patients or 25.3% were delivered vaginally. There were 62 cases of significant uterine rupture with no maternal deaths.   I will never claim to be an expert at critiquing research, so hope that someone can offer some suggestion.  My question is this...it says that there were 62 ruptures but they dont say exactly which  groups these ruptures occurred in- was it just the women with previous cs history? Was it just the whole numbers, ie including those without cs history?  As it reads it doesnt really say specifically.   It also reads: In women attempting vaginal delivery after a previous lower segment Caesarean section, the uterine rupture rate was estimated at 0.3%, with 0.05% experiencing a perinatal death and 0.05% requiring a hysterectomy.   What are the current figures relating to women having cs requiring hystorectomy??   Can anyone chat to me about this soon as i am writing a report on a document that will have HUGE impact on vbac acre here isn SA...and possibly not for the good!   cheers Jo Bainbridge