This study concludes that for women attempting VBAC no previous vaginal birth …

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Biology Articles » Reproductive Biology » Factors predisposing to perinatal death related to uterine rupture during attempted vaginal birth after caesarean section: retrospective cohort study » Tables

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- Factors predisposing to perinatal death related to uterine rupture during attempted vaginal birth after caesarean section: retrospective cohort study

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Table 1 Maternal demographic and obstetric characteristics in relation to perinatal death due to uterine rupture. Figures are numbers (percentages) unless stated otherwise

No perinatal death*(n=35 837) Perinatal death (n=17) P value Median (IQR) age (years) 29 (26-32) 27 (25-31) 0.61 Median (IQR) height (cm) 161 (157-165) 158 (153-163) 0.13 Height data missing 2927 (8.2) 2 (11.8) 0.64 Marital status: Married 28 548 (79.7) 15 (88.2) >0.9 Other 7 289 (20.3) 2 (17.8) Fifth of deprivation distribution: 1 (least deprived) 6 418 (17.9) 2 (11.8) 0.82 2 6 731 (18.8) 3 (17.6)   3 6 854 (19.1) 2 (11.8)   4 7 219 (20.1) 5 (29.4)   5 (most deprived) 8 182 (22.8) 5 (29.4)   Missing 433 (1.2) 0 (0.0) No of previous vaginal births None 23 176 (64.7) 15 (88.2) 0.04 One or more 12 661 (35.3) 2 (11.8) No of spontaneous abortions: None 27 574 (76.9) 12 (70.6) 0.57 1 8 263 (23.1) 5 (29.4) No of therapeutic abortions: None 32 202 (89.9) 16 (94.1) >0.9 1 3 635 (10.1) 1 (5.9) Year of delivery: 17 539 (48.9) 9 (52.9) 0.74 1992 18 298 (51.1) 8 (47.1) Median (IQR) No of deliveries in hospital in given year 3120 (1794-4 129) 2154 (1681-2718) 0.05 Sex of infant: Female 17 594 (49.1) 11 (64.7) 0.23 Male 18 243 (50.9) 6 (35.3) Median (IQR) weight (g) of infant 3445 (3118-3780) 3242 (3150-3840) 0.76

IQR=interquartile range.

^* Includes 35 730 women who did not have uterine rupture documented and 107 women who had uterine rupture documented but it did not result in stillbirth or neonatal death of infant.

Mann-Whitney U test or Fisher's exact test, as appropriate.

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Table 2 Univariate obstetric associations with uterine rupture and perinatal death due to uterine rupture. Figures are numbers (percentages) unless stated otherwise

Uterine rupture Perinatal death due to uterine rupture Characteristics Yes (n=124) No (n=35 730) Relative risk (95% CI) P value* Yes (n=17) No(n=35 837) Relative risk (95% CI) P value* 63 (50.8) 16 930 (47.4) 1.1 (0.8 to 1.6) 0.47 13 (76.5) 16 980 (47.4) 3.6 (1.2 to 11.1) 0.03 No previous vaginal birth 102 (82.3) 23 089 (64.6) 2.5 (1.6 to 4.0) 15 (88.2) 23 176 (64.7) 4.1 (0.9 to 17.9) 0.04 Induction of labour without prostaglandin 13 (10.5) 4416 (12.4) 1.1 (0.6 to 2.0) 0.75 2 (11.8) 4427 (12.4) 1.2 (0.3 to 5.6) 0.68 Induction of labour with prostaglandin 39 (31.4) 4436 (12.4) 3.3 (2.2 to 4.8) 5 (29.4) 4470 (12.5) 3.0 (1.0 to 8.8) 0.05 Gestation >41 weeks 8 (6.4) 1867 (5.2) 1.2 (0.6 to 2.6) 0.54 0 (0.0) 1875 (5.2) — >0.9

^* Fisher's exact test (two sided).

Includes 35 730 women who did not have uterine rupture documented and 107 women who had uterine rupture documented but it did not result in stillbirth or neonatal death.

Same reference category for both: all women in whom labour was not induced.

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Table 3 Multivariate analysis (with odds ratios and 95% confidence intervals) of risk of uterine rupture and perinatal death due to uterine rupture

All uterine rupture Perinatal death due to uterine rupture Characteristics Adjusted OR (95% CI)* P value Adjusted OR (95% CI)* P value 1.1 (0.8 to 1.5) 0.67 3.4 (1.0 to 14.3) 0.04 No previous vaginal birth 2.5 (1.6 to 3.9) 4.1 (0.9 to 36.6) 0.06 Induction of labour with prostaglandin 2.9 (2.0 to 4.3) 2.5 (0.7 to 7.7) 0.17

^* Adjusted for each of other factors.

Also adjusted for year of delivery.

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Table 4 Factors associated with perinatal death among women with documented uterine rupture. Figures are numbers (percentages) unless stated otherwise

Characteristics Uterine rupture led to perinatal death (n=17) Uterine rupture did not lead to perinatal death (n=107) Relative risk (95% CI) P value* Adjusted odds ratio (95% CI) P value 13 (76.5) 50 (46.7) 3.1 (1.1 to 9.1) 0.03 3.9 (1.2 to 12.8) 0.03 No previous vaginal birth 15 (88.2) 87 (81.3) 1.6 (0.4 to 6.6) 0.73 1.7 (0.4 to 8.3) 0.79 Induction of labour with prostaglandin 5 (29.4) 34 (31.8) 0.9 (0.3 to 2.4) >0.9 0.8 (0.2 to 2.6) 0.85

^* Fisher's exact test.

From exact logistic regression.

Univariate odds ratio=3.7. Higher value of adjusted odds ratios compared with relative risk is due to relatively high incidence of event in group.

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 Source: BMJ  2004;329:375 (14 August)