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Neonatal neurological morbidity associated with uterine rupture

  • Miriam Martínez-Biarge , Alfredo García-Alix , Fátima García-Benasach , Francisco Gayá , Ana Alarcón , Antonio González and José Quero
Published/Copyright: August 4, 2008

Abstract

Aims: To compare neonatal neurological morbidity associated with uterine rupture with morbidity associated with a non-reassuring fetal status.

Methods: We conducted a retrospective cohort analysis. Twenty-one cases of term infants delivered after a symptomatic uterine rupture were analyzed and compared with a randomly selected group of 63 infants born after a non-reassuring fetal heart rate pattern.

Results: Prevalence of uterine rupture was 0.058%. Maternal factors and infant general data were similar in both groups. Infants delivered after a uterine rupture had lower Apgar scores at 1 and 5 min, lower umbilical blood pH, and required more advanced resuscitation than infants delivered after a non-reassuring fetal status. Prevalence of hypoxic-ischemic encephalopathy in the uterine rupture group was 33%, compared with 5% in the other group (P<0.01, relative risk 3.7). Four infants in the uterine rupture group (19%) had moderate or severe encephalopathy; all of them had also multisystem dysfunction and an adverse outcome. No infant in the non-reassuring fetal status group showed moderate or severe encephalopathy.

Conclusions: Uterine rupture is a considerable sentinel event that involves a high rate of early and late neurological morbidity in the newborn infant.


Corresponding author: Alfredo García-Alix, MD, PhD Department of Pediatrics, Neonatology Division La Paz University Hospital Paseo de la Castellana 261 28046 Madrid Spain Tel.: +34 917277416 Fax: +34 917277480

Received: 2008-2-9
Revised: 2008-5-11
Accepted: 2008-6-18
Published Online: 2008-08-04
Published Online: 2008-08-04
Published in Print: 2008-11-01

©2008 by Walter de Gruyter Berlin New York

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