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Risk of Uterine Rupture w/o induction?
Hi Everyone,
I am 29 weeks pregnant and finally decided to go for the VBAC full-throttle. I'm changing providers sometime this week.
I have read a lot of research about the uterine rupture risk with induction, but I can't seem to find anything related to spontaneous labor uterine rupture risk. Does the "less than 1 percent" account for spontaneous labor or induced labor?
I am perfectly ok with being in labor for days if that's what it takes, but induction of any kind (except maybe the blub) scares the c.r.@.p. out of me. I feel like I'll be waiting for something bad to happen the entire time.
Thank you!
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Re: Risk of Uterine Rupture w/o induction?
Both rupture risks (induced and natural) are under 1%. There are some great articles posted on the blog that Iris put together.
I've always loved the perspective this gives:
https://birthblissdoulaservices.blogspot.com/2010/03/odds-of-uterine-rupture-for-vbacs.html
I also wanted to add this site too- it has additional stats:
https://misskalypso.wordpress.com/2011/06/04/relative-risks-of-uterine-rupture/
What's the link to the blog? TIA!
The risk for both is under 1%, though with induced labors, it's a bit higher.
UR risk with spontaneous labor is about .5% or so. From here (the quote is about halfway down the page, under "Rates of Rupture: Spontaneous vs. Induced/Augmented Labors":
"...Lyndon-Rochelle (2001) found that women with spontaneous labors had a rupture rate of 5.2 per 1000 (0.52%)"
Here's the blog link - https://vbacbumpies.blogspot.com/
DS2 - Oct 2010 (my VBAC baby!)
The risk for induction looked high to me on that second link- here is what the actual study said. It doesn't read clearly to me:
RESULTS:
The risk of complete uterine rupture among women without labour was 0.01%. The risk in spontaneous labour without augmentation was 0.15%, considerably higher when there was augmentation with oxytocin (1.91%). The risk with induction of labour was 0.54% for oxytocin alone, 0.68% for prostaglandin alone, 0.63% without either and 0.88% when they were combined. Compared with spontaneous labour, risks were increased three- to five-fold for any induction, six-fold for prostaglandin combined with oxytocin and 14-fold for augmentation with oxytocin.
How can both of those statements be true? Australians. . . ;-)
Here is a New England Journal of Medicine article that's one of the definitive sources for these statistics. See Table 3 in this link to the full text:
https://www.nejm.org/doi/full/10.1056/NEJMoa040405#t=articleResults
What it says: Risk of rupture in spontaneous (that means not induced) labor is .4% (4 out of 1,000), less than half the 1% (1 out of 100) for induced. Note that in most cases rupture is not that serious and can be easily repaired.