Uterine rupture and dehiscence: ten-year review and case-control study

South Med J. 2002 Apr;95(4):431-5.


Background: Previous cesarean section, oxytocin administration, and fetal macrosomia increase the risk of uterine rupture or dehiscence (URD).

Methods: All 25,718 deliveries at Riverside Regional Medical Center from January 1990 to June 2000 were reviewed to describe complications and identify risk factors for URD.

Results: Eleven uterine ruptures and 10 dehiscences occurred during this period (0.08%). One maternal death (5%) and three neonatal deaths (14%) occurred. Other complications included intrapartum nonreassuring fetal status (67%), 5-minute Apgar score < 7 (52%), maternal blood transfusion (24%), neonatal hypoxic injury (14%), hysterectomy (14%), and endometritis (10%). Uterine rupture/dehiscence was independently associated with fetal weight > or = 4,000 g, nonreassuring fetal status, use of oxytocin, and previous cesarean delivery; internal fetal monitoring reduced the risk of URD.

Conclusions: To reduce the risk of URD, a delivery plan should include assessment of cesarean history and fetal macrosomia,judicious use of oxytocin, and intrapartum monitoring for nonreassuring fetal status.

MeSH terms

  • Adolescent
  • Adult
  • Apgar Score
  • Case-Control Studies
  • Cesarean Section / adverse effects*
  • Female
  • Fetal Macrosomia / complications*
  • Fetal Monitoring
  • Fetal Weight
  • Humans
  • Infant, Newborn
  • Oxytocin / adverse effects*
  • Pregnancy
  • Pregnancy Outcome
  • Risk Factors
  • Surgical Wound Dehiscence / etiology*
  • Surgical Wound Dehiscence / prevention & control
  • Time Factors
  • Uterine Rupture / etiology*
  • Uterine Rupture / prevention & control


  • Oxytocin