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Tinelli A, Kosmas IP, Carugno JT, Carp H, Malvasi A, Cohen SB, Laganà AS, Angelini M, Casadio P, Chayo J, Cicinelli E, Gerli S, Palacios Jaraquemada J, Magnarelli G, Medvediev MV, Metello J, Nappi L, Okohue J, Sparic R, Stefanović R, Tzabari A, Vimercati A. Uterine rupture during pregnancy: The URIDA (uterine rupture international data acquisition) study. Int J Gynaecol Obstet 2021; 157:76-84. [PMID: 34197642 DOI: 10.1002/ijgo.13810] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/23/2021] [Accepted: 06/30/2021] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To describe the characteristics and peripartum outcomes of patients diagnosed with uterine rupture (UR) by an observational cohort retrospective study on 270 patients. METHODS Demographic information, surgical history, symptoms, and postoperative outcome of women and neonates after UR were collected in a large database. The statistical analysis searched for correlation between UR, previous uterine interventions, fibroids, and the successive perinatal outcomes in women with previous UR. RESULTS Uterine rupture was significantly associated with previous uterine surgery, occurring, on average, at 36 weeks of pregnancy in women also without previous uterine surgery. UR did not rise exponentially with an increasing number of uterine operations. Fibroids were related to UR. The earliest UR occurred at 159 days after hysteroscopic myomectomy, followed by laparoscopic myomectomy (251 days) and laparotomic myomectomy (253 days). Fertility preservation was feasible in several women. Gestational age and birth weight seemed not to be affected in the subsequent pregnancy. CONCLUSION Data analysis showed that previous laparoscopic and abdominal myomectomies were associated with UR in pregnancy, and hysteroscopic myomectomy was associated at earlier gestational ages. UR did not increase exponentially with an increasing number of previous scars. UR should not be considered a contraindication to future pregnancies.
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Affiliation(s)
- Andrea Tinelli
- Department of Obstetrics and Gynecology and CERICSAL (CEntro di RIcerca Clinico SALentino), "Veris delli Ponti Hospital", Scorrano, Lecce, Italy.,Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy, Vito Fazzi Hospital, Lecce, Italy.,Laboratory of Human Physiology, Phystech BioMed School, Faculty of Biological & Medical Physics, Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia.,Department of Obstetrics and Gynecology, Veris delli Ponti Hospital, Scorrano & Vito Fazzi Hospital, Lecce, Italy
| | - Ioannis P Kosmas
- Laboratory of Human Physiology, Phystech BioMed School, Faculty of Biological & Medical Physics, Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia.,Department of Obstetrics and Gynecology, Ioannina State General Hospital G. Hatzikosta, University of Ioannina, Ioannina, Greece
| | - Jose Tony Carugno
- MIGS/Robotics Division Director, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Howard Carp
- Department of Obstetrics and Gynecology, Sheba Medical Center, TLV University, Tel Hashomer, Israel
| | - Antonio Malvasi
- Laboratory of Human Physiology, Phystech BioMed School, Faculty of Biological & Medical Physics, Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia.,Department of Obstetrics and Gynecology, Santa Maria Hospital, GVM Care & Research, Bari, Italy
| | - Shlomo B Cohen
- Department of Obstetrics and Gynecology, Sheba Medical Center, TLV University, Tel Hashomer, Israel
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Marta Angelini
- Department of Obstetrics and Gynecology, Medical School, University of Udine, Udine, Italy
| | - Paolo Casadio
- Department of Obstetrics and Gynecology, Medical School, University of Bologna, Bologna, Italy
| | - Jenifer Chayo
- Department of Obstetrics and Gynecology, Sheba Medical Center, TLV University, Tel Hashomer, Israel
| | - Ettore Cicinelli
- Department of Obstetrics and Gynecology, Medical School, University of Bari, Bari, Italy
| | - Sandro Gerli
- Department of Obstetrics and Gynecology, Medical School, University of Perugia, Perugia, Italy
| | - Josè Palacios Jaraquemada
- Department of Obstetrics and Gynecology, Medical School, University of Buenos Aires, Buenos Aires, Argentina
| | - Giulia Magnarelli
- Department of Obstetrics and Gynecology, Medical School, University of Bologna, Bologna, Italy
| | - Mykhailo V Medvediev
- Department of Obstetrics and Gynecology, University of Dnepropetrovsk medical academy of Health Ministry of Ukraine, Dnepropetrovsk, Ukraine
| | - Josè Metello
- Centro de Infertilidade e Reprodução Medicamente Assistida, Hospital Garcia de Orta, Almada, Portugal
| | - Luigi Nappi
- Department of Obstetrics and Gynecology, Medical School, University of Foggia, Foggia, Italy
| | - Jude Okohue
- Department of Obstetrics and Gynecology, Madonna University Teaching Hospital, Port Harcourt, Nigeria
| | - Radmila Sparic
- Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, Serbia
| | - Radomir Stefanović
- Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, Serbia
| | - Avinoam Tzabari
- Department of Obstetrics and Gynecology, Hospital Mayane Hayeshua Medical Center, Bnei Brak, Israel
| | - Antonella Vimercati
- Department of Obstetrics and Gynecology, Medical School, University of Bari, Bari, Italy
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