Induction of labor in women with a uterine scar |
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| Authors: | David Stenson Tove Wallstrom Maria Sjostrand Helena Akerud Kristina Gemzell-Danielsson |
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| Institution: | 1. Department of Clinical Science and Education, Section of Obstetrics and Gynecology, Karolinska Institute, Soder Hospital, Sweden,;2. Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden, and;3. Department of Women’s and Children’s Health, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden |
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| Abstract: | Objective: To evaluate the frequency of uterine rupture following induction of labor in women with a previous cesarean section. Misoprostol was compared to other methods of induction.Methods: A retrospective cohort study of 208 women attempting induction of labor after one previous cesarean section. Delivery data were collected retrospectively and compared. Group 1(2009–2010) was compared with Group 2 (2012–2013). In Group 1, the main method of induction was vaginal PGE2 (prostaglandin-E2), amniotomy, oxytocin or a balloon catheter. In Group 2, the dominant method of induction was an oral solution of misoprostol. Main outcome measures: frequency of uterine rupture in the two groups.Results: Nine cases (4.3%) of uterine rupture occurred. There was no significant difference in the frequency of uterine rupture following the change of method of induction from PGE2, amniotomy, oxytocin or mechanical dilatation with a balloon catheter to orally administered misoprostol (4.1 versus 4.6%, p?=?0.9). All ruptures occurred in women with no prior vaginal delivery.Conclusion: The shift to oral misoprostol as the primary method of induction in women with a previous cesarean section did not increase the frequency of uterine rupture in the cohort studied. |
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| Keywords: | Induction of labor misoprostol PGE2 TOLAC uterine scar |
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