3207.0: Monday, November 13, 2000 - 4:45 PM

Abstract #3318

Maternal and infant outcomes associated with uterine rupture

Judith Weiss, ScD1, Angela Nannini, FNP, PhD1, Linda Bartlett, MD, MHS2, Eugene Declercq, PhD3, Mary Barger, CNM, MPH3, Lauren Khalil3, and Jane Kim4. (1) Bureau of Family and Community Health, Massachusetts Department of Public Health, 250 Washington St. 5th floor, Boston, MA 02108, 617-624-5634, judy.weiss@state.ma.us, (2) Division of Reproductive Health, CDC, 4770 Buford Hwy, NE, MSK23, Atlanta, GA 30341, (3) School of Public Health, Dept. of Maternal and Child Health, Boston University, 715 Albany St, Boston, MA 02118, (4) Registry of Vital Records, Massachusetts Department of Public Health, 150 Mt. Vernon St, 1st Floor, Dorchester, MA 02125

While uterine rupture (UR) is a potentially life-threatening condition for both mother and infant, the severity of UR varies from inconsequential to catastrophic. A population-based study in Massachusetts examined maternal and infant outcomes related to UR including hysterectomy, maternal death, low apgar scores, long-term infant prognosis, and fetal/infant death. Using hospital discharge data and hospital chart review, 293 cases of UR were identified from 1994-1997, of which 270 (92%) occurred among women with a prior cesarean section. Overall, 7% of UR cases had poor maternal outcomes; 21 women had a hysterectomy and there were no maternal deaths. Poor outcomes attributable to UR were found in 16% of the infants. Forty-four infants had 5 minute apgar scores <7, among whom 84% were primarily or partially caused by the UR. However, the long-term prognosis was good for 72% of the infants who lived. Of the 13 fetal and infant deaths, nine (4 fetal and 5 infant) were directly attributable to the UR. The majority of UR cases resulted in no significant long-term morbidity for mother or infant. At the same time, UR caused severe reproductive health consequences and perinatal mortality among a substantial minority of cases. Differentiating UR cases by degree of severity is an important step toward understanding and preventing these catastrophic outcomes.

Learning Objectives: During this session, participants will learn about the results of a recent study examining maternal and infant outcomes related to uterine rupture. At the conclusion of this session, the participant will be able to: 1. Articulate the methods used to identify cases of uterine rupture. 2. Define poor maternal and infant outcomes associated with uterine rupture. 3. Describe the proportion of cases with poor outcomes

Keywords: Maternal Morbidity, Data/Surveillance

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA