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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Milner, 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 / 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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1619-3997
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In This Section
Volume 36, Issue 6 (Nov 2008)

Issues

Neonatal neurological morbidity associated with uterine rupture

Miriam Martínez-Biarge
  • 1Department of Pediatrics, Neonatology Division, La Paz University Hospital, Madrid, Spain
/ Alfredo García-Alix
  • 2Department of Pediatrics, Neonatology Division, La Paz University Hospital, Madrid, Spain
/ Fátima García-Benasach
  • 3Department of Obstetrics and Gynecology, La Paz University Hospital, Madrid, Spain
/ Francisco Gayá
  • 4Biostatistics Unit, La Paz University Hospital, Madrid, Spain
/ Ana Alarcón
  • 5Department of Neonatology, Unitat Integrada Hospital Sant Joan de Deu-Hospital Clinic, Barcelona, Spain
/ Antonio González
  • 6Department of Obstetrics and Gynecology, La Paz University Hospital, Madrid, Spain
/ José Quero
  • 7Department of Pediatrics, Neonatology Division, La Paz University Hospital, Madrid, Spain
Published Online: 2008-08-04 | DOI: https://doi.org/10.1515/JPM.2008.078

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.

Keywords: Neonatal hypoxic-ischemic encephalopathy; neurodevelopmental outcome; non-reassuring fetal status; perinatal brain injury; uterine rupture

About the article

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: 2008-02-09

Revised: 2008-05-11

Accepted: 2008-06-18

Published Online: 2008-08-04

Published Online: 2008-08-04

Published in Print: 2008-11-01



Citation Information: Journal of Perinatal Medicine, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/JPM.2008.078. Export Citation

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