Prevalence of uterine rupture among women with one prior low transverse cesarean and women with unscarred uterus undergoing labor induction with PGE2: A systematic review and meta-analysis

As uterine rupture may affect as many as 11/1000 women with 1 prior cesarean birth and 5/10.000 women with unscarred uterus undergoing labor induction, we intended to estimate the prevalence of such rare outcome when PGE2 is used for cervical ripening and labor induction. We searched MEDLINE, Clinic...

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Bibliographic Details
Published in:PloS one 2021-07, Vol.16 (7), p.e0253957
Main Authors: Chiossi, Giuseppe, D'Amico, Roberto, Tramontano, Anna L, Sampogna, Veronica, Laghi, Viola, Facchinetti, Fabio
Format: Article
Language:English
Subjects:
Adult
Biology and Life Sciences
Cervix
Cesarean Section
Childbirth & labor
Cohort analysis
Complications and side effects
Dinoprostone - pharmacology
Female
Fetuses
Health aspects
Health risks
Humans
Induced labor
Labor
Labor, Induced
Medicine and Health Sciences
Meta-analysis
Obstetrics
Patient outcomes
Physical Sciences
Pregnancy
Pregnant women
Prevalence
Prostaglandin E2
Prostaglandins E
Publication Bias
Research and Analysis Methods
Reviews
Ripening
Rupture
Rupturing
Software packages
Systematic review
Uterine Rupture - epidemiology
Uterus
Uterus - drug effects
Uterus - pathology
Vagina
Womens health
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Summary:As uterine rupture may affect as many as 11/1000 women with 1 prior cesarean birth and 5/10.000 women with unscarred uterus undergoing labor induction, we intended to estimate the prevalence of such rare outcome when PGE2 is used for cervical ripening and labor induction. We searched MEDLINE, ClinicalTrials.gov and the Cochrane library up to September 1st 2020. Retrospective and prospective cohort studies, as well as randomized controlled trials (RCTs) on singleton viable pregnancies receiving PGE2 for cervical ripening and labor induction were reviewed. Prevalence of uterine rupture was meta-analyzed with Freeman-Tukey double arcsine transformation among women with 1 prior low transverse cesarean section and women with unscarred uterus. We reviewed 956 full text articles to include 69 studies. The pooled prevalence rate of uterine rupture is estimated to range between 2 and 9 out of 1000 women with 1 prior low transverse cesarean (5/1000; 95%CI 2-9/1000, 122/9000). The prevalence of uterine rupture among women with unscarred uterus is extremely low, reaching at most 0.7/100.000 (
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0253957