Re: [ozmidwifery] ObGynWorld.com mail a colleague

[Jen Semple]

Here's the article so you don't all have to register if you don't want to:

 

Trial of labor uterine rupture risk exaggerated
Source: British Medical Journal 2004; 329: 19-25

Results of a systematic review indicate that the risk of uterine rupture in women attempting labor after a previous cesarean delivery is only small.

While uterine rupture is more likely with trial of labor than elective cesarean after a previous surgical delivery, the difference is only small, and the risk is not eradicated by opting for a cesarean, say researchers.

"Since at least 1916, the time of Edward Cragin's famous statement, 'Once a cesarean always a cesarean,' the medical profession has been concerned about the risk of catastrophic uterine rupture for women whose previous deliveries were by cesarean section," the team explains.

To assess the size of this risk, Jeanne-Marie Guise (Oregon Health and Science University, Portland, USA) and colleagues reviewed 568 articles that had been published since 1980. They then whittled these down to 21 fair quality studies.

Analysis indicated that a trial of labor increased the risk of uterine rupture by 2.7 per 1000 cases, perinatal death by 1.4 per 10,000 cases, and hysterectomy by 3.4 per 10,000 cases, compared with elective repeat cesarean. Asymptomatic rupture, on the other hand, was equally common in both groups of women.

"Although the literature on uterine rupture is imprecise and inconsistent, existing studies indicate that 370 elective cesarean deliveries would need to be performed to prevent one symptomatic rupture," Guise et al conclude.

Posted: 5 July 2004

[EMAIL PROTECTED] wrote:

Dear Colleague,
I thought this article from ObGynWorld.com might interest you:

Trial of labor uterine rupture risk exaggerated
http://www.ObGynWorld.com/international/news/2004/week_28/day_1/trial_of_labor_uteri.asp

ObGynWorld.com is the essential resource in obstetrics and gynecology, offering the latest news plus feature articles and an extensive range of clinical information. Visit the site at www.ObGynWorld.com.

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