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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

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  • Giuseppe Chiossi
  • Roberto D’Amico
  • Anna L Tramontano
  • Veronica Sampogna
  • Viola Laghi
  • Fabio Facchinetti

Abstract

Background: 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. Methods: 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. Results: 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 (

Suggested Citation

  • Giuseppe Chiossi & Roberto D’Amico & Anna L Tramontano & Veronica Sampogna & Viola Laghi & Fabio Facchinetti, 2021. "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," PLOS ONE, Public Library of Science, vol. 16(7), pages 1-18, July.
  • Handle: RePEc:plo:pone00:0253957
    DOI: 10.1371/journal.pone.0253957
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