Aslan Halil, Unlu Emine, Agar Mehmet, Ceylan Yavuz
Department of Perinatology, SSK Bakirkoy Maternity and Children Hospital, Defne 02-03 B-10, Daire 17, 34850 Bahcesehir, Istanbul, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2004 Mar 15;113(1):45-8. doi: 10.1016/S0301-2115(03)00363-4.
To review our experience with uterine rupture in patients undergoing a trial of labor with a history of previous cesarean delivery in which labor was induced with misoprostol.
A retrospective chart review was used to select patients who underwent induction of labor with misoprostol during the period from February 1999 to June 2002. Women with a history of cesarean delivery were retrospectively compared with those without uterine scarring.
Uterine rupture occurred in 4 of 41 patients with previous cesarean delivery who had labor induced with misoprostol. The rate of uterine rupture (9.7%) was significantly higher in patients with a previous cesarean delivery (P<0.001). No uterine rupture occurred in 50 patients without uterine scarring. Women with a history of cesarean delivery were more likely to have oxytocin augmentation than those without uterine scarring (41% versus 20%; P=0.037).
Misoprostol induction of labor increases the risk of uterine rupture in women with a history of cesarean delivery.
回顾我们对有剖宫产史且使用米索前列醇引产进行试产的患者发生子宫破裂的经验。
采用回顾性病历审查,选取1999年2月至2002年6月期间使用米索前列醇引产的患者。对有剖宫产史的女性与无子宫瘢痕的女性进行回顾性比较。
41例有剖宫产史且使用米索前列醇引产的患者中有4例发生子宫破裂。有剖宫产史患者的子宫破裂率(9.7%)显著更高(P<0.001)。50例无子宫瘢痕的患者未发生子宫破裂。有剖宫产史的女性比无子宫瘢痕的女性更有可能使用缩宫素加强宫缩(41%对20%;P=0.037)。
米索前列醇引产会增加有剖宫产史女性发生子宫破裂的风险。