Bak, J.C.G (2014) Uterusrupturen in het Medisch Spectrum Twente. Een onderdeel van de URTOL studie. thesis, Medicine.
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Abstract
Uterine rupture is a severe complication with far-reaching consequences. The Dutch Society of Obstetrics and Gynaecology (NVOG) defines an uterine rupture as a connection between the uterine cavity and the abdominal cavity. In literature different definitions are used to describe uterine ruptures. A risk factor for utrine rupture is ‘trial of labour’, this can be defined as pursuing vaginal delivery in women with a caesarean scar. The Medisch Spectrum Twente (MST) participated in 2011 in the PROBAAT-S trial (PROstaglandins of Balloon for induction of labour in women with AT least one previous Caesarean Section). The preliminary results of this study showed a higher incidence of uterine rupture in the MST among women undergoing a trial of labour in comparison to the national average. The URTOL (Uterine rupture after Trial of Labour) study was designed in occasion of this findings. The purpose of the URTOL study was to determine if the incidence of uterine ruptures in the MST was higher in comparison to the national average during a period of 11 years. Possible causes would be determined, if our study showed a higher incidence of uterine rupture. The current study is a descriptive study that is part of the URTOL study. Our study focuses mainly on the determination of the incidence of uterine rupture. Besides that a survey was given of uterine rupture in the MST. Characteristics of the population with a uterine rupture were given, as well as the symptoms and neonatal and maternal morbidity and mortality after a rupture has taken place. Methods. In this retrospective descriptive study women were included who had a uterine rupture between 1 January 2002 and 31 December 2012. Uterine ruptures were selected by spectating all operation reports and correspondence from medical practitioners belonging to caesareans, which had taken place during the study period. There was determined if a uterine rupture was remarked during the caesarean section. The incidence of uterine rupture was determined when using the definition of the NVOG. Results. 15 patiënts with an uterine rupture were included with a mean age of 32,5 years. This resulted in an incidence of 8,5 per 10.000 deliveries. This incidence did not differ significantly from the nationale average in secondary care centres according to the LEMMoN study (p=0,54). Conclusion. This study showed that the incidence of uterine ruptures in the MST was not significantly higher than the national average. The explanation for the seemingly higher incidence in the PROBAAT-S study was: 1) The short study period of the PROBAAT-S study (13 months). 2) The unclear definition of the phenomenon uterine rupture in the PROBAAT-S study, which led to incomparability of the two studies.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Brons, dr. J.T.J and UMCG |
| Supervisor name: | Brons, dr. J.T.J and Zuijdgeest, I. and Medisch Spectrum Spectrum Twente and Gynaecologie |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:06 |
| Last Modified: | 25 Jun 2020 11:06 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2613 |
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