Prediction of complete uterine rupture by sonographic evaluation of the lower uterine segment

被引:151
作者
Bujold, Emmanuel [1 ,2 ]
Jastrow, Nicole [2 ]
Simoneau, Jessica [2 ]
Brunet, Suzanne [2 ]
Gauthier, Robert J. [2 ]
机构
[1] Univ Laval, Fac Med, Dept Obstet & Gynaecol, CRCHUQ, Quebec City, PQ G1V 4G2, Canada
[2] Univ Montreal, Fac Med, Dept Obstet & Gynaecol, Hop St Justine, Montreal, PQ H3C 3J7, Canada
关键词
ultrasound; uterine rupture; vaginal birth after cesarean delivery; PRETERM CESAREAN DELIVERY; 1ST PRENATAL VISIT; VAGINAL BIRTH; INTERDELIVERY INTERVAL; RISK; WOMEN; COMPLICATIONS; THICKNESS; LABOR;
D O I
10.1016/j.ajog.2009.06.014
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: The purpose of this study was to establish the validity of sonographic evaluation of lower uterine segment (LUS) thickness for complete uterine rupture STUDY DESIGN: A prospective cohort study of women with previous cesarean delivery was conducted. LUS thickness (full thickness and myometrial thickness only) was measured between 35 and 38 weeks gestation, and the thinnest measurement was considered to be the dependent variable. Receiver operating curve analyses and logistic regression were used. RESULTS: Two hundred thirty-six women were included in the study. Nine uterine scar defects (3 cases of complete rupture during a trial of labor and 6 cases of dehiscence) were reported. Receiver operating curve analyses showed that full thickness of <2 3 mm was the optimal cutoff for the prediction of uterine rupture (3/33 vs 0/92, P=.02) Full thickness was also identified as an independent predictor of uterine scar defect (odds ratio, 4.66, 95% confidence interval, 1.04-20.91) CONCLUSION: Full LUS thickness of <2 3 mm is associated with a higher risk of complete uterine rupture.
引用
收藏
页码:320.e1 / 320.e6
页数:6
相关论文
共 23 条
[1]   The impact of a single-layer or double-layer closure on uterine rupture [J].
Bujold, E ;
Bujold, C ;
Hamilton, EF ;
Harel, F ;
Gauthier, RJ .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2002, 186 (06) :1326-1330
[2]   Interdelivery interval and uterine rupture [J].
Bujold, E ;
Mehta, SH ;
Bujold, C ;
Gauthier, RJ .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2002, 187 (05) :1199-1202
[3]   Neonatal morbidity associated with uterine rupture: What are the risk factors? [J].
Bujold, E ;
Gauthier, RJ .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2002, 186 (02) :311-314
[4]   Assessment of the rate of uterine rupture at the first prenatal visit: A preliminary evaluation [J].
Bujold, Emmanuel ;
Jastrow, Nicole ;
Gauthier, Robert J. .
JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE, 2008, 21 (07) :507-508
[5]   Maternal and perinatal complications with uterine rupture in 142,075 patients who attempted vaginal birth after cesarean delivery: A review of the literature [J].
Chauhan, SP ;
Martin, JN ;
Henrichs, CE ;
Morrison, JC ;
Magann, EF .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2003, 189 (02) :408-417
[6]   Sonographic Measurement of the Lower Uterine Segment Thickness in Women With Previous Caesarean Section [J].
Cheung, Vincent Y. T. .
JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA, 2005, 27 (07) :674-681
[7]   Sonographic evaluation of the lower uterine segment in patients with previous cesarean delivery [J].
Cheung, VYT ;
Constantinescu, OC ;
Ahluwalia, BS .
JOURNAL OF ULTRASOUND IN MEDICINE, 2004, 23 (11) :1441-1447
[8]   A COEFFICIENT OF AGREEMENT FOR NOMINAL SCALES [J].
COHEN, J .
EDUCATIONAL AND PSYCHOLOGICAL MEASUREMENT, 1960, 20 (01) :37-46
[9]   EXAMINATION OF PREVIOUS CESAREAN-SECTION SCARS BY ULTRASOUND [J].
FUKUDA, M ;
FUKUDA, K ;
MOCHIZUKI, M .
ARCHIVES OF GYNECOLOGY AND OBSTETRICS, 1988, 243 (04) :221-224
[10]   Predicting incomplete uterine rupture with vaginal sonography during the late second trimester in women with prior cesarean [J].
Gotoh, H ;
Masuzaki, H ;
Yoshida, A ;
Yoshimura, S ;
Miyamura, T ;
Ishimaru, T .
OBSTETRICS AND GYNECOLOGY, 2000, 95 (04) :596-600