Journal of Perinatal Medicine
Official Journal of the World Association of Perinatal Medicine
Editor-in-Chief: Dudenhausen, Joachim W.
Editorial Board Member: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Ogata, Edward / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland
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Neonatal neurological morbidity associated with uterine rupture
1Department of Pediatrics, Neonatology Division, La Paz University Hospital, Madrid, Spain
2Department of Pediatrics, Neonatology Division, La Paz University Hospital, Madrid, Spain
3Department of Obstetrics and Gynecology, La Paz University Hospital, Madrid, Spain
4Biostatistics Unit, La Paz University Hospital, Madrid, Spain
5Department of Neonatology, Unitat Integrada Hospital Sant Joan de Deu-Hospital Clinic, Barcelona, Spain
6Department of Obstetrics and Gynecology, La Paz University Hospital, Madrid, Spain
7Department of Pediatrics, Neonatology Division, La Paz University Hospital, Madrid, Spain
Citation Information: Journal of Perinatal Medicine. Volume 36, Issue 6, Pages 536–542, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: 10.1515/JPM.2008.078, August 2008
- Published Online:
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.
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