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Obstetrics & Gynecology 2002;99:585-588
© 2002 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

The Association of Maternal Age and Symptomatic Uterine Rupture During a Trial of Labor After Prior Cesarean Delivery

Thomas D. Shipp, MD, Carolyn Zelop, MD, John T. Repke, MD, Amy Cohen, Aaron B. Caughey, MPP, MPH and Ellice Lieberman, MD, DrPH

From the Departments of Obstetrics and Gynecology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, University of Connecticut Health Center, Farmington, Connecticut, University of Nebraska Medical Center, University of Nebraska, Omaha, Nebraska, and University of California, San Francisco, San Francisco, California.

Address reprint requests to: Thomas D. Shipp, MD, Brigham and Women’s Hospital, Department of Obstetrics and Gynecology, CWN 3, 75 Francis Street, Boston, MA 02115; E-mail: tshipp{at}partners.org.

OBJECTIVE: To estimate whether maternal age is associated with a symptomatic uterine rupture during a trial of labor after prior cesarean delivery.

METHODS: We retrospectively reviewed the medical records of all patients undergoing a trial of labor after prior cesarean delivery over a 12-year period. We analyzed the labors of women with one prior cesarean and no prior vaginal deliveries. The uterine rupture rate was determined with respect to maternal age. Multiple logistic regression was used to control for potential confounding variables.

RESULTS: Overall, 32 (1.1%) uterine ruptures occurred among 3015 women. For women younger than 30 years, the risk of uterine rupture was 0.5%, and for those women aged at least 30 years, the risk of uterine rupture was 1.4% (P = .02). Controlling for birth weight, induction, augmentation, and interdelivery interval, the odds ratio for symptomatic uterine rupture for women aged at least 30 years compared with those less than 30 years was 3.2 (95% confidence interval 1.2, 8.4).

CONCLUSION: Women aged 30 years or older have a greater risk of uterine rupture as compared with women younger than 30 years.




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