Uterine rupture and risk factors for caesarean delivery following induced labour in women with one previous lower segment caesarean section

Abstract

Objective: To determine the outcome of induction of labor, specifically incidence of uterine rupture and reliable predictors of repeat caesarean delivery, in women undergoing induction of labor after previous caesarean section. Methods: A review of obstetric and perinatal records of 167 women who had their labor induced after one transverse lower uterine incision performed at previous caesarean delivery in a referral tertiary hospital in Nigeria between January 2006 and December 2009. Results: The incidence of uterine rupture was 2.4%. Independent risk factors for repeat caesarean delivery were absence of prior vaginal delivery (OR 3.7; 95% CI 1.9–7.1), duration of latent phase >2 h (OR 4.3; 95% CI 1.7–11.2), postdated pregnancy (OR 2.2; 95% CI 1.1–4.0) and previous caesarean for non-recurrent indication (OR 2.1; 95% CI 1.1–4.0). Conclusion: Choice of appropriate delivery option for this cohort of women based on the identified risk factors is essential to minimize the incidence of failed vaginal birth and its associated adverse maternal and neonatal outcome.

Keywords::

• Caesarean section
• induction
• labor
• uterine rupture

Acknowledgments

The authors wish to acknowledge the contributions of the Consultants and Resident Doctors of the Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin City, Nigeria.

Declaration of Interest: The authors declare that there is no conflict of interest in relation to this work.