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<h2>Risk of uterine rupture during labor is higher for women with a prior cesarean delivery</h2>
<p>Researchers at the University of Washington have found that women with a prior cesarean section who undergo labor for their second child are at increased risk for rupture of the uterus compared with women who elect to have another c-section. Uterine rupture is an uncommon but serious obstetrical condition that may result in hysterectomy, urologic injury, or a need for blood transfusion for the mother and neurologic impairment in the infant. Each year in the United States, approximately 60 percent of women with a prior cesarean delivery elect to have a trial of labor in a subsequent pregnancy.</p>
<p>The researchers analyzed the records of more than 20,000 women who had their first child delivered by c-section in Washington State from 1987 through 1996 and also delivered a second child either by cesarean or following labor during the same time period. They found that a total of 91 women had a uterine rupture during the second birth. Women with a spontaneous onset of labor were 3.3 times more likely to have a uterine rupture than women who had a repeat c-section without labor. Uterine rupture was highest when prostaglandin&#8212;a naturally occurring substance in the body that is sometimes used to induce labor&#8212;was used for the second birth. Compared with women who had repeat c-sections without labor, women who were induced without prostaglandin were nearly five times more likely to have a uterine rupture, and women with prostaglandin induction were 15 times more likely to have uterine rupture.</p>
<p>The study was led by Mona Lydon-Rochelle, Ph.D., and supported by the Agency for Healthcare Research and Quality (National Research Service Award T32 HS00034) and the National Institute of Nursing Research at the National Institutes of Health.</p>
<p>For more information, see "Risk of uterine rupture during labor among women with a prior cesarean delivery," by Dr. Lydon-Rochelle, Victoria L. Holt, Ph.D., Thomas R. Easterling, M.D., and Diane P. Martin, Ph.D., in the July 5, 2001, <em>New England Journal of Medicine</em> 345(1), pp. 3-8.</p>
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