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22-Feb-2018 06:06

The use of oxytocin for labor augmentation versus labor induction is often quite different.

The two patient populations widely vary in their key attributes, as well as in the oxytocin doses that are typically given, which systematically varies between the two groups.

The search terms were uterine rupture, pregnancy and prior cesarean section, vaginal birth after cesarean, VBAC, trial of labor (TOL), trial of labor after cesarean (TOLAC), uterine scar dehiscence, and pregnancy and myomectomy. Articles published from 1976 through May, 2012 that described the incidence of uterine rupture and that included sufficient information regarding the authors' definitions of uterine rupture and of uterine scar dehiscence were incorporated for review. A total of 133 published articles were included for data extraction and analysis.

Meta-analysis of pooled data from 25 studies in the peer-reviewed medical literature published from 1976-2012 indicated an overall incidence of pregnancy-related uterine rupture of 1 per 1,416 pregnancies (0.07%).

If cesarean delivery is needed, it is for other obstetrical indications and not for fetal distress attributable to the uterine disruption.

Numerous factors are known to increase the risk of uterine rupture, but even in high-risk subgroups, the overall incidence of uterine rupture is low.The premonitory signs and symptoms of uterine rupture are inconsistent, and the short time for instituting definitive therapeutic action makes uterine rupture in pregnancy a much feared event for medical practitioners.Uterine rupture during pregnancy is a rare event and frequently results in life-threatening maternal and fetal compromise.No cases of uterine rupture occurred among 21,998 primigravidas, and only 2 (0.0051%) occurred among 39,529 multigravidas with no uterine scar.

A meta-analysis of 8 large, modern (1975-2009) studies from industrialized countries revealed 174 uterine ruptures among 1,467,534 deliveries.It can either occur in women with (1) a native, unscarred uterus or (2) a uterus with a surgical scar from previous surgery.

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