Choose your font:
 Mukta Malar
 Open Sans Condensed
 Source Sans Pro


[Valid RSS] RSS

Database - Alliance francophone pour l'accouchement respecté (AFAR)

Description of this bibliographical database (AFAR website)
Currently 3046 records
YouTube channel (tutorial)

Created on : 01 Feb 2006
Modified on : 02 Dec 2007

 Modify this record
Do not follow this link unless you know an editor’s password!

Share: Facebook logo   Tweeter logo   Hard

Bibliographical entry (without author) :

Rupture of the uterine scar during term labor: contractility or biochemistry?. {USA}. BJOG. 2005 Jan;112(1):38-42.

Author(s) :

Buhimschi CS, Buhimschi IA, Patel S, Malinow AM, Weiner CP.

Year of publication :


URL(s) :…

Résumé (français)  :

Abstract (English)  :

OBJECTIVE: Vaginal birth after a prior low transverse caesarean section (VBAC) is advocated as a safe and effective method to reduce the total caesarean section rate. However, the risk of uterine rupture has dampened the enthusiasm of practising clinicians for VBAC. Uterine rupture occurs more frequently in women receiving prostaglandins in preparation for the induction of labour. We hypothesised that similar to the cervix, prostaglandins induces biochemical changes in the uterine scar favouring dissolution, predisposing the uterus to rupture at the scar of the lower segment as opposed to elsewhere.

DESIGN: We tested aspects of this hypothesis by investigating the location of uterine rupture associated with prostaglandins and compared it with the sites of rupture in the absence of prostaglandins. SETTINGS: Two North American University Hospitals. POPULATION: Twenty-six women with a prior caesarean section, experiencing uterine rupture in active labour.

METHODS: Retrospective review of all pregnancies complicated by uterine rupture at two North American teaching hospitals from 1991 to 2000. MAIN OUTCOME MEASURE: Site of the uterine rupture. RESULTS: Thirty-four women experienced rupture after a previous caesarean section with low transverse uterine incision. Ten of the women who ruptured (29%) received prostaglandins for cervical ripening (dinoprostone: n= 8 or misoprostol: n= 2) followed by either spontaneous contractions (n= 3) or oxytocin augmentation during labour (n= 7). In 16 women (47%), oxytocin alone was sufficient for the induction/augmentation of labour. Eight (23%) women ruptured at term before reaching the active phase of labour in the absence of pro-contractile agents or attempted VBAC. There were no differences among the groups in terms of age, body mass index, parity, gestational age, fetal weight or umbilical cord pH measurements. Women treated with prostaglandins experienced rupture at the site of their old scar more frequently than women in the oxytocin-alone group whose rupture tended to occur remote from their old scar (prostaglandins 90%vs oxytocin 44%; OR: 11.6, 95% CI: 1.2-114.3).

CONCLUSION: Women in active labour treated with prostaglandins for cervical ripening appear more likely to rupture at the site of their old scar than women augmented without prostaglandins. We propose that prostaglandins induce local, biochemical modifications that weaken the scar, predisposing it to rupture.

Sumário (português)  :

Comments :

Fiche importée de avec l’aide de Ken Turkowski, septembre 2005

Argument (français) :

Argument (English):

Argumento (português):

Keywords :

➡ vaginal birth after caesarean ; evidence-based medicine/midwifery ; physiology ; c-section/caesarean ; induction of labor ; misoprostol (Cytotec) ; oxytocin ; post-term pregnancy ; scars

Author of this record :

Cécile Loup — 01 Feb 2006

Discussion (display only in English)
➡ Only identified users

 I have read the guidelines of discussions and I accept all terms (read guidelines)


New expert query --- New simple query

Creating new record --- Importing records

User management --- Dump database --- Contact


This database is managed by Alliance francophone pour l'accouchement respecté (AFAR,
affiliated with Collectif interassociatif autour de la naissance (CIANE,
It is fed by the voluntary contributions of persons interested in the sharing of scientific data.
If you agree with this project, you can support us in several ways:
(1) contributing to this database if you have a minimum training in documentation
(2) or financially supporting AFAR (see below)
(3) or joining the AFAR (or another society affiliated with CIANE).
Sign in or create an account to follow changes or become an editor.
Contact afar.association(arobase) for more information.

Valid CSS! Valid HTML!
Donating to AFAR (click “Faire un don”) will help us to maintain and develop sites and public
databases towards the support of parents and caregivers’ informed decisions with respect to childbirth