Obstetrics & Gynecology Track the topics, authors and articles important to you
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Obstetrics & Gynecology 2002;100:946-950
© 2002 by The American College of Obstetricians and Gynecologists
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Chauhan, S. P.
Right arrow Articles by Martin, J. N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Chauhan, S. P.
Right arrow Articles by Martin, J. N., Jr

ORIGINAL RESEARCH

Pregnancy After Classic Cesarean Delivery

Suneet P. Chauhan, MD, Everett F. Magann, MD, Christopher D. Wiggs, MD, P. Scott Barrilleaux, MD and James N. Martin, Jr, MD

From the Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi and Spartanburg Regional Medical Center, Spartanburg, South Carolina.

Address reprint requests to: Suneet P. Chauhan, MD, Division of Maternal-Fetal Medicine, Regional Women’s Health Care, 853 North Church Street, Suite 610, Spartanburg, SC 29303; E-mail: mfmchauhan{at}aol.com.

OBJECTIVE: To describe maternal and perinatal outcomes after a prior classic cesarean delivery.

METHODS: A retrospective review was performed including all patients from 1990–2000 whose most recent pregnancy was preceded by classic cesarean delivery.

RESULTS: During the 11-year period, there were 37,863 deliveries and 157 patients (0.4%) underwent classic cesarean operations. In the next pregnancy, one case of uterine rupture (0.6%, 95% confidence interval 0.1, 3.5) occurred at 29 weeks without preterm labor and resulted in fetal death. The prevalence of asymptomatic dehiscence was 9% (95% confidence interval 5, 15). There was no significant difference between patients with uterine dehiscence (n = 15) and patients with intact uteri (n = 141) with regard to maternal demographics, duration of labor, cervical dilatation at time of surgery, transfusion of packed red cells, bowel injury, postpartum endometritis, wound breakdown, thrombophlebitis, or umbilical arterial pH less than 7.00 (P > .05). Duration of labor, cervical dilatation, and gestational age at repeat cesarean delivery were poor predictors for uterine rupture or dehiscence.

CONCLUSION: Among patients with prior classic cesarean delivery, uterine rupture and dehiscence are neither predictable nor preventable. One in four patients will experience some form of maternal morbidity. Uterine rupture, although infrequent, can be fatal to the fetus. Uterine dehiscence, however, does not increase neonatal or peripartum maternal morbidity.




This article has been cited by other articles:


Home page
 Obstet GynecolHome page
A. C. Sciscione, M. B. Landon, K. J. Leveno, C. Y. Spong, C. MacPherson, M. W. Varner, D. J. Rouse, A. H. Moawad, S. N. Caritis, M. Harper, et al.
Previous Preterm Cesarean Delivery and Risk of Subsequent Uterine Rupture
Obstet. Gynecol., March 1, 2008; 111(3): 648 - 653.
[Abstract] [Full Text] [PDF]

Home page
 Obstet GynecolHome page
J. R. Jackson
The Problem With Evidence-Based Statistical Language
Obstet. Gynecol., March 1, 2003; 101(3): 616 - 616.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2002 by the American College of Obstetricians and Gynecologists.