Print Email Facebook Twitter Uterine rupture in the Netherlands: A nationwide population-based cohort study Title Uterine rupture in the Netherlands: A nationwide population-based cohort study Author Zwart, J.J. Richters, J.M. Öry, F. de Vries, J.I.P. Bloemenkamp, K.W.M. van Roosmalen, J. Publication year 2009 Abstract Objective: To assess incidence of uterine rupture in scarred and unscarred uteri and its maternal and fetal complications in a nationwide design. Design: Population-based cohort study. Setting: All 98 maternity units in the Netherlands. Population: All women delivering in the Netherlands between August 2004 and August 2006 (n = 371 021). Methods: Women with uterine rupture were prospectively collected using a web-based notification system. Data from all pregnant women in the Netherlands during the study period were obtained from Dutch population-based registers. Results: were stratified by uterine scar. Main outcome measures: Population-based incidences, severe maternal and neonatal morbidity and mortality, relative and absolute risk estimates. Results: There were 210 cases of uterine rupture (5.9 per 10 000 pregnancies). Of these women, 183 (87.1%) had a uterine scar, incidences being 5.1 and 0.8 per 10 000 in women with and without uterine scar. No maternal deaths and 18 cases of perinatal death (8.7%) occurred. The overall absolute risk of uterine rupture was 1 in 1709. In univariate analysis, women with a prior caesarean, epidural anaesthesia, induction of labour (irrespective of agents used), pre- or post-term pregnancy, overweight, non-Western ethnic background and advanced age had an elevated risk of uterine rupture. The overall relative risk of induction of labour was 3.6 (95% confidence interval 2.7-4.8). Conclusion: The population-based incidence of uterine rupture in the Netherlands is comparable with other Western countries. Although much attention is paid to scar rupture associated with uterotonic agents, 13% of ruptures occurred in unscarred uteri and 72% occurred during spontaneous labour. © RCOG 2009 BJOG An International Journal of Obstetrics and Gynaecology. Chemicals / CAS: misoprostol, 59122-46-2, 59122-48-4; oxytocin, 50-56-6, 54577-94-5; prostaglandin E2, 363-24-6; sulprostone, 60325-46-4, 96420-78-9 Subject HealthIncidencePopulation basedUnscarred uterusUterine ruptureVBACMisoprostolOxytocinProstaglandinProstaglandin E2SulprostoneAbdominal painAfricaCesarean sectionCohort analysisEpidural anesthesiaEthnic groupEthnicityFar EastMajor clinical studyMaternal morbidityMaternal mortalityMiddle earMiddle EastMoroccoMuscle hypertoniaNewborn morbidityNewborn mortalityObesityPregnancy terminationScarSurinameTurkey (republic)Vagina bleedingWestern EuropeAdultCicatrixDelivery, ObstetricFemaleHumansMiddle AgedNetherlandsPregnancyProspective StudiesRisk FactorsSocioeconomic FactorsTrial of LaborUterine RuptureVaginal Birth after CesareanYoung Adult To reference this document use: http://resolver.tudelft.nl/uuid:a4248ad1-4685-4509-af33-8cb157dc49e7 DOI https://doi.org/10.1111/j.1471-0528.2009.02136.x TNO identifier 241621 ISSN 1470-0328 Source BJOG: An International Journal of Obstetrics and Gynaecology, 116 (8), 1069-1078 Document type article Files To receive the publication files, please send an e-mail request to TNO Library.