Uterine rupture and its complications in the Netherlands: a prospective study

OBJECTIVE: To determine maternal and perinatal morbidity and mortality after uterine rupture in the Netherlands. STUDY DESIGN: All 100 Dutch obstetric departments were asked to participate in a prospective nationwide registration of uterine rupture between 1st April 2002 and 1st April 2003. For every case, a questionnaire about obstetrical history, current pregnancy and delivery, maternal and neonatal outcome was completed. RESULTS: Eighty-nine percent of all hospitals in the Netherlands participated. Ninety-eight uterine ruptures were registered; 95 after a previous caesarean section (CS) of which 91 occurred during a trial of labour. The fetus was extruded in the abdominal cavity completely in 18 cases and partially in 13 cases. Major complications due to uterine rupture were: perinatal death (n=11, from 94 cases with a viable fetus, 11.7%) and hysterectomy (n=4, 4.1%). CONCLUSION: These severe complications, perinatal death and hysterectomy, have to be an issue when counselling women on an elective CS and women with a history of a CS on the route of delivery.