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Uterine Rupture

Uterine rupture is a serious obstetric complication where the uterine wall tears, potentially leading to life-threatening maternal and fetal complications.
This condition can occur during pregnancy or labor, often due to prior uterine surgery, excessive uterine distension, or trauma.
Prompt recognition and management are critical to prevent adverse outcomes.
PubCompare.ai's AI-driven platform can help researchers and clinicians streamline the process of identifying the best protocols and products for managing uterine rupture, enhancing reproducibility and accuracy in this important area of women's health.

Most cited protocols related to «Uterine Rupture»

Among the final sample (n = 1413) information on maternal weight at the time of birth was missing in 8.6% (n = 122), and information on height in 11.0% (n = 156) of women. We assumed that missing data had occurred at random, i.e., that missings were not influenced by unobserved data. We applied imputation procedures using the average of five iterations with IVEware [21 ]. Imputation of maternal height was based on migration status and age; imputations of maternal weight were based on migration status, age, and height. Results of an analysis without imputed data do not differ substantially from the results given in Table 1 and Table 2 (see appendix, Table 4 and Table 5).

Characteristics of the selected subsample of women, by migration status

Turkish originLebanese originNon-immigrants
N133721208
Age in years *** 1)
 Median (range)25 (18–45)24 (18–41)30 (18–44)
Highest educational level (%) *** 2)
 No qualification/primary school36 (27.1%)14 (19.4%)28 (2.3%)
 Secondary school72 (54.1%)34 (47.2%)530 (43.9%)
 University / technical collage / vocational school / a-level vocational diploma25 (18.8%)24 (33.3%)650 (53.8%)
Body Mass Index at admission (%) n.s. 2)
 BMI < 25 kg/m217 (12.8%)17 (23.6%)235 (19.5%)
 BMI < 30 kg/m266 (49.6%)28 (38.9%)546 (45.2%)
 BMI ≥30 kg/m250 (37.6%)27 (37.5%)427 (35.4%)
Oxytocic agent n.s. 2)
 Yes (%)74 (55.6%)33 (45.8%)611 (50.6%)
Cervical dilatation * 2)
 Median (range) in cm2 (0–8)2 (0–10)2 (0–10)
 Active phase of labor (≥4 cm) in %21 (15.8%)19 (26.4%)315 (26.1%)
Delivery mode (%) ** 2)
 Normal vaginal delivery75 (56.4%)52 (72.2%)685 (56.7%)
 Vacuum extraction / forceps37 (27.8%)10 (13.9%)234 (19.4%)
 Emergency cesarean delivery21 (15.8%)10 (13.9%)289 (23.9%)
Obstetric complicationsAll participants (1403)
 HELLP-Syndrome6 (0.4%)
 Eclampsia0
 Hemorrhage > 1000 ml23 (1.6%)
 Sepsis0
 Cardiovascular complications0
 Uterine rupture< 5 **

* p < 0.05, ** p < 0.01, *** p < 0.001

1) Kruskal-Wallis test

2) Chi-square test

** no detailed data due to data protection

Indications for cesarean delivery

RankTurkish originN (%)Lebanese originN (%)Non-immigrant womenN (%)
1Pathological CTG or auscultatory bad fetal heart tones40 (30.1)Pathological CTG or auscultatory bad fetal heart tones17 (23.6)Pathological CTG or auscultatory bad fetal heart tones317 (26.8)
2Protracted labor/obstructed labor in the expulsion stage18 (13.5)Green amniotic fluid5 (6.9)Protracted labor/obstructed labor in the expulsion stage148 (12.3)
3Protracted labor/obstructed labor in the dilation stage9 (6.8)Chorioamnionitis syndrome4 (6.0)Protracted labor/obstructed labor in the dilation stage72 (6.6)
4Chorioamnionitis syndrome6 (4.5)Protracted labor/obstructed labor in the dilation stage4 (6.0)Green amniotic fluid43 (3.6)
5Green amniotic fluid3 (2.3)Protracted labor/obstructed labor in the expulsion stage4 (6.0)Absolute or relative imbalance between child‘s head and mother‘s pelvis29 (2.4)

Category “other birth risks” was not considered

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Publication 2019
Amnion Auscultation Birth Cardiovascular System Care, Prenatal Child Chorioamnionitis Dilatations, Cervical Emergencies Fetal Heart Head Heart Auscultation HELLP Syndrome Hemorrhage Immigrants Index, Body Mass Mothers Obstetric Delivery Obstetric Labor Oxytocics Pathological Dilatation Uterine Rupture Vacuum Extraction, Obstetrical Vagina Woman
We used commonly used definitions for maternal age, marital status, and education.29 (link) We classified maternal complications into mutually exclusive categories of direct obstetric complications and medical diseases. Direct obstetric complications included uterine rupture, placenta praevia, abruptio placentae, unspecified antepartum haemorrhage, pre-eclampsia, eclampsia, HELLP syndrome, or any fetal malpresentation (breech, shoulder, or other). Medical diseases included heart disease, embolism/thrombophlebitis, hepatic disease, severe anaemia (haemoglobin <70 g/L), renal disease (including urinary tract infection), lung disease (including upper respiratory tract infection), HIV/AIDS, connective tissue disorders, gestational diabetes mellitus, and cancer.
We categorised women into risk groups for caesarean section using a modified version of the Robson classification.31 (link)
32 (link) Because there is no agreement on the optimal caesarean section rate in the population, and indications for caesarean sections are not standardised, Robson proposed a system that classifies women into 10 groups based on their obstetric characteristics (parity, previous caesarean section, gestational age, onset of labour, fetal presentation, and number of fetuses).31 (link) The size of each group and the caesarean section rate within each group correspond to an expected range. Monitoring caesarean sections within the Robson groups therefore allows the evaluation of clinical practice, including whether the caesarean section rate is justified. We adapted Robson’s classification because the NMNMSS did not collect information on whether or not the labour was induced. We created eight mutually exclusive categories: nulliparous, singleton, cephalic, ≥37 weeks’ gestation; multiparous, singleton, cephalic, ≥37 weeks’ gestation without a uterine scar; uterine scar, singleton, cephalic, ≥37 weeks’ gestation; all nulliparous women with a singleton breech; all multiparous women with a singleton breech, including those with a uterine scar; all multiple pregnancies, including those with uterine scar; all women with a single pregnancy in other abnormal lie, including those with uterine scar; and all singleton, cephalic, ≤36 weeks’ gestation pregnancies, including those with uterine scar.
For the institutional data we calculated the number of obstetricians per 1000 births using the number of births reported in the NMNMSS in 2015. We also report the region in which the hospital is located, using China’s standard definitions for region (western, central, and eastern).33 We extracted the day of the week from the date of delivery.
We report the number of perinatal deaths (stillbirths and early neonatal deaths within seven days of delivery before discharge), pregnancy related deaths, and uterine rupture. Stillbirths were defined as reported previously.29 (link) Pregnancy related deaths were defined as deaths from any cause in women who died after 28 completed weeks of gestation or with a fetus of birth weight 1000 g or higher (including women who died undelivered). Uterine rupture was defined as uterine or lower uterine dehiscence in late pregnancy or during childbirth, including complete and incomplete rupture.34
Publication 2018
Abruptio Placentae Acquired Immunodeficiency Syndrome Anemia Birth Birth Weight Cesarean Section chrysarobin Cicatrix Connective Tissue Diseases Eclampsia Embolism Fetus Gestational Age Gestational Diabetes Heart Diseases HELLP Syndrome Hemorrhage Kidney Diseases Liver Diseases Lung Diseases Malignant Neoplasms Mothers Obstetric Delivery Obstetrician Patient Discharge Placenta Previa Population at Risk Pre-Eclampsia Pregnancy Shoulder Thrombophlebitis Upper Respiratory Infections Urinary Tract Infection Uterine Rupture Uterus Woman
The study was conducted in six (6) hospitals in Tigray, Ethiopia, from January 30 to March 30, 2016. Hospitals were randomly selected from 16 public hospitals in the region[14 ]. The study was a facility-based, unmatched case control design. Sample size was estimated using a double population proportion formula based on a study from Morocco that showed hypertensive disease contributing the most to MNM [15 (link)]. Based on the Morocco study, we hypothesized the proportion of chronic hypertension to be double in cases (63.9%) and controls (47%) at a 95% confidence level and 80% power of the test, with a 1:2 ratio for cases and controls. Final sample size was 308, of which 103 were cases and 205 controls.
We considered MNM as a condition meeting any of the five disease-specific criteria proposed by Filippi [16 (link)]. In sampled hospitals, using medical notes, any woman diagnosed with at least one of the following complications was considered as a case: severe obstetric hemorrhage leading to shock; hypertensive diseases of pregnancy, including eclampsia and severe preeclampsia; dystocia, including uterine rupture and impending rupture; infections, including hyper- or hypothermia or a clear source of infection and clinical signs of shock, and; anemia, including low hemoglobin (<6 g/dl) or clinical signs of severe anemia in women without hemorrhage. Women not meeting the above criteria were considered as controls. Cases were sequentially recruited whereas controls were selected through systematic sampling. Data was collected using a structured questionnaire, administered in-person by nurse midwives. Socio-demographic characteristics, obstetric history, and knowledge of pregnancy-related danger signs were collected.
Questionnaire was based on tools validated by the World Health Organization (WHO) and in different literature and adapted to include context-specific factors [11 –13 , 15 (link), 17 (link)]. Questionnaire was prepared in English, translated to Tigrigna, and back-translated to English separately by two individuals to ensure consistency. Data was collected by 12 nurse midwives with experience in obstetric care. Data collection was supervised and data checked for consistency and completeness. Incomplete and unclear questionnaires were returned to interviewers to be completed.
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Publication 2017
Anemia Dystocia Eclampsia Hemoglobin Hemorrhage High Blood Pressures Infection Interviewers Nurse Midwife Pre-Eclampsia Pregnancy Shock Uterine Rupture Woman
In this prospective cohort study, we included all women with MNM according to the sub-Saharan Africa or original WHO MNM criteria. Identification of MNM was a two-step process—we first identified all women with potentially life-threatening conditions (PLTC) as defined by WHO (severe postpartum hemorrhage, severe pre-eclampsia, eclampsia, uterine rupture, severe complications of abortion, and sepsis/severe systemic infections); received critical interventions (use of blood products, laparotomy other than cesarean section); or were admitted to the intensive care unit [8 ]. At discharge, we then selected those who developed life-threatening complications, consisting of MNM and maternal deaths, according to the sub-Saharan Africa or original WHO MNM criteria [8 ,20 ]. Maternal near miss refers to a woman who nearly died but survived a life-threatening complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy [7 (link)]. Severe maternal outcome includes women with life-threatening complications who survived the complications (near miss) or died. Eligible women were identified by trained research assistant nurse-midwives working in both hospitals through daily visits of obstetric ward, intensive care unit, emergency room, and gynaecology ward. Identified cases were evaluated and confirmed by the first author (AKT). Sample size was estimated based on the annual deliveries and maternal mortality ratio according to the recommendation by the WHO [22 ]. Considering the existing maternal mortality ratio (412) and the annual number of deliveries in both hospitals, we expected 7000 live births and 30 maternal deaths in 16 months.
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Publication 2018
Blood Cesarean Section Eclampsia Induced Abortions Laparotomy Maternal Death Mothers Nurse Midwife Obstetric Delivery Patient Discharge Postpartum Hemorrhage Pre-Eclampsia Pregnancy Septicemia Severe Sepsis Uterine Rupture Woman
This prospective observational multicenter study was conducted at 6 academic perinatal centers from December 2012 to October 2015 (NCT01747863). Infants were screened if they were admitted to the NICU, ⩾ 36 weeks of gestation and had evidence of hypoxia–ischemia during the perinatal period. The later included a pH ⩽ 7.0 or a base deficit ⩾ 16 mmol l−1 in arterial or venous umbilical cord blood or any blood specimen during the 1st hour after birth. If the pH was 7.01 to 7.15, or base deficit 10 to 15.9 mmol per liter, or if a blood gas was not available, additional criteria were required. These included an acute obstetric event (for example, late or variable decelerations, cord prolapse, cord rupture, uterine rupture, maternal trauma, hemorrhage or cardiorespiratory arrest) and either a 10-min Apgar score ⩽ 5 or assisted ventilation initiated at birth and continued ⩾ 10 min. Infants who fulfilled these criteria underwent a standardized neurological examination at <6 h of age using the Sarnat score as modified by the Eunice Kennedy Shriver National Institute of Child Health and Human Development NICHD-NRN (Neonatal Research Network) trial of hypothermia.10 (link) The score evaluated six categories: level of consciousness, spontaneous activity, posture, tone, primitive reflexes (suck and Moro) and autonomic nervous system (pupils, heart rate and respiration). Each category was scored for pre-defined signs consistent with normal, mild, moderate or severe. Infants with ⩾ 1 abnormal category but no evidence of moderate or severe NE (defined as moderate and/or severe abnormality in three categories) were classified as mild NE. Exclusion criteria included a completely normal neurological exam, inability to enroll at ⩽ 6 h of life, presence of a major congenital abnormality or severe growth restriction (birth weight ⩽ 1800 g). The Institutional Review Board of each participating center approved the study and written informed consent was obtained from parents.
Publication 2017
Apgar Score Arteries Birth Weight BLOOD Cardiopulmonary Arrest Childbirth Cone-Rod Dystrophy 2 Congenital Abnormality Consciousness Deceleration Ethics Committees, Research Hemorrhage Hypoxia Infant Infant, Newborn Ischemia Mothers Nervous System, Autonomic Neurologic Examination Parent Pregnancy Prolapse Pupil Rate, Heart Reflex Respiration Umbilical Cord Blood Uterine Rupture Veins Wounds and Injuries

Most recents protocols related to «Uterine Rupture»

This retrospective cohort study included women with one previous LSCS who followed up and delivered their current pregnancy at Hospital Universiti Sains Malaysia (USM), Kelantan, Malaysia, between January 01, 2016, and December 31, 2017. Hospital USM is a public tertiary care hospital. The study was approved by the Human Research Ethics Committee of USM, Malaysia, and relevant permissions were obtained from the Director of Hospital USM to review the medical records.
Women who were aged ≥18 years, had singleton pregnancy, and had previously undergone an LSCS for their last delivery were included. Those with a classical CS (previously or in the current pregnancy), presenting for preterm birth (<37 weeks) in the current pregnancy, non-cephalic pregnancy, lethal fetal anomalies, with uterine rupture, with severe pre-eclampsia, and those who underwent elective CS for any other reason in the current pregnancy were excluded from the study.
Publication 2023
Ethics Committees, Research Fetal Anomalies Homo sapiens Obstetric Delivery Pre-Eclampsia Pregnancy Premature Birth Uterine Rupture Woman
Type of study Retrospective observational study and data were obtained from medical records only and Institutional ethics committee clearance was obtained prior to the conduct of the study.
Place of study Department of Obstetrics and Gynaecology, Swaroop Rani Hospital, MLN Medical College, Prayagraj.
Duration of study 30 months [15 months of prepandemic period (March 2018 to May 2019) and 15 months of pandemic period (March 2020 to May 2021)].
India had its first COVID-19 case on January 27, 2020, in Kerala [4 (link)], but Prayagraj had the first case on March 22, 2020, and lockdown was applied from March 23, 2020.
Based on the data from the Johns Hopkin’s Resource Centre pandemic period in India was divided into three phases: ‘pandemic-wave1 rising (Mar-Sep 2020)’, ‘pandemic-wave1 receding (Oct20-Feb21)’ and ‘pandemic-wave 2 rising (Mar-May 2021)’ [5 ].
Inclusion criteria All obstetric emergencies in prepandemic period and all non-COVID-19 Obstetric emergencies in pandemic period.
Exclusion criteria COVID-19 infected pregnant patients.
All the patients were divided in two groups:
Study group- All non-COVID-19 obstetric emergencies in pandemic period.
Control group- All obstetric emergencies in pre-pandemic period.
Parameters analyzed and compared were:

Monthly hospital births.

Obstetric referrals and bad state referrals.

General condition of the patient was assessed using critical, unstable, potentially unstable and stable (CUPS) assessment and critical, unstable, potentially unstable patients were ascertained as the bad state referral while stable patients as average state referral.

Monthly non-COVID-19 maternal mortalities.

Causes of maternal mortality:

Postpartum hemorrhage (PPH).

Eclampsia.

Pre-eclampsia.

Septic abortion (sepsis following spontaneous or induced abortion).

Puerperal infection.

Uterine rupture.

Heart failure in pregnancy or postpartum.

Jaundice with Hepatic Encephalopathy.

Antepartum Hemorrhage (APH).

In cases of multiple co-morbidities, the primary complication was ascertained as main cause of death.
- GRSI score and its impact on hospital births and non-COVID-19 maternal mortalities.
We used the time series data on the Government Response Stringency Index (GRSI) to calculate monthly average GRSI scores for India.
Publication 2023
Abortion, Septic Congestive Heart Failure COVID 19 Eclampsia Emergencies Hemorrhage Hepatic Encephalopathy Icterus Induced Abortions Institutional Ethics Committees Pandemics Patients Postpartum Hemorrhage Pre-Eclampsia Pregnancy Puerperal Infection Septicemia Uterine Rupture
Maternal variables that were considered were the following: age, ethnicity, parity, mode of conception (natural or with assisted reproduction technology, ART), pre-pregnancy and term body mass index (BMI), indication for previous CS, indication for labor induction, gestational age at CRB insertion, amniorexis after CRB removal, oxytocin induction, oxytocin augmentation, epidural analgesia, mode of delivery, indication for CS or operative vaginal delivery, and presence of maternal complications. We also considered a composite adverse maternal outcome (CAMO), defined as the presence of one or more of the following major complications: post-partum hemorrhage (blood loss > 1000 mL), uterine rupture, need for laparotomy, need for hysterectomy, post-partum infection, and need for blood transfusion.
Fetal variables considered were the following: birthweight, incidence of pathological fetal heart rate (FHR) tracing during labor according to FIGO classification [14 (link)], Apgar score at 1 and 5 min, umbilical artery pH, and admission to neonatal intensive care unit (NICU). We also considered a composite adverse fetal outcome (CAFO), including major fetal complications.
The primary outcome of the study was the VBAC rate; secondary outcomes were the rates of pathological FHR tracing, Apgar score < 7 at 5 min, arterial pH < 7.1, NICU admission.
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Publication 2023
Analgesia, Epidural Apgar Score Arteries Assisted Reproductive Technologies Birth Weight Blood Transfusion Care, Prenatal Conception Ethnicity Gestational Age Hemorrhage Hysterectomy Index, Body Mass Labor, Induced Laparotomy Mothers Obstetric Delivery Obstetric Labor Oxytocin Postpartum Hemorrhage Pregnancy Puerperal Infection Umbilical Arteries Uterine Rupture Vagina
Nationality was considered as the exposure, and women were categorised into four groups, namely, Lebanese, Syrian, Palestinian and migrant women of other nationalities who are mainly domestic workers (online supplemental table 3). Other than maternal age, ICD-10-CM codes and nationality, all other variables were imputed by classification using ML methods. Caesarean section in the current pregnancy was generated using a combination of ICD-10-CM codes and classification. Other characteristics extracted from the ‘free-text’ were gestational age, parity, consanguinity, smoking, current number of caesarean sections, diabetes, hypertension and episiotomy. Primary caesarean section was defined as performing the caesarean section for the first time.
Maternal outcomes extracted from the ‘free-text’ included diabetes, hypertension disorders during pregnancy (including pregnancy induced hypertension and preeclampsia), placenta abruption, placenta praevia, placenta accreta spectrum, hysterectomy, uterine rupture and blood transfusion. Infant outcomes extracted were preterm birth (<37 weeks of gestational age), very preterm birth (<32 weeks of gestational age) and intrauterine fetal death (IUFD). Use of caesarean section was calculated as a proportion by dividing the number of caesarean sections by the total number of maternities for each nationality. Serious complication of pregnancy was a composite outcome that included preeclampsia, hysterectomy, placenta accreta spectrum, placenta praevia, blood transfusion, placenta abruption and uterine rupture.
Publication 2023
Abruptio Placentae Blood Transfusion Cesarean Section Diabetes Mellitus Episiotomy Fetal Death Gestational Age High Blood Pressures Hypertension, Gestational Hysterectomy Infant Mesocricetus auratus Migrants Mothers Palestinians Placenta Accreta Placenta Previa Pre-Eclampsia Pregnancy Pregnancy Complications Premature Birth Uterine Rupture Woman Workers

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Publication 2023
Asphyxia Birth Child Hyperbilirubinemia, Neonatal Pregnancy Uterine Rupture

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More about "Uterine Rupture"

Uterine rupture is a severe obstetric complication characterized by a tear or break in the uterine wall.
This life-threatening condition can occur during pregnancy or labor, often due to prior uterine surgery, excessive uterine distension, or trauma.
Early recognition and prompt management are critical to prevent adverse maternal and fetal outcomes.
Uterine rupture can lead to severe bleeding, organ damage, and even maternal or fetal death if not addressed quickly.
Risk factors include previous uterine scarring from C-sections, myomectomies, or other procedures, as well as conditions that cause excessive uterine stretching, such as macrosomia, polyhydramnios, or multiple gestation.
Symptoms of uterine rupture may include sudden onset of abdominal pain, vaginal bleeding, fetal distress, and hemodynamic instability.
Diagnostic tools like ultrasound, CT scans, and laparoscopy can help confirm the diagnosis.
Immediate surgical intervention, such as emergency cesarean delivery and uterine repair or hysterectomy, may be necessary to save the life of the mother and baby.
Researchers and clinicians can leverage AI-driven platforms like PubCompare.ai to streamline the process of identifying the best protocols and products for managing uterine rupture.
By comparing data from literature, preprints, and patents, these tools can enhance the reproducibility and accuracy of research in this critical area of women's health.
This can lead to improved patient outcomes and better understanding of the most effective treatments for this serious obstetric complication.