Women who have a vaginal delivery after a caesarean section face three times the risk of uterine rupture than those who have a second caesarean section, a new report has said (New England Journal of Medicine 2001;345:3-8).
Moreover, the risk of rupture was five times greater in women whose labour was induced by prostaglandins than in those whose labour was spontaneous.
Researchers at the University of Washington in Seattle reached these conclusions from a retrospective cohort analysis of 20095 women who delivered their first baby via caesarean section and then had a second child.
Ninety one cases of uterine rupture overall were recorded. Uterine rupture occurred in 1.6 per 1000 deliveries among women with a repeat caesarean delivery without labour (11 women) and in 24.5 per 1000 deliveries among women with prostaglandin induced labour (9 women).