Risk Factors for Scar Ruptures During Labour in Patients with Previous History of Cesarean Section

Résumé

Introduction: Cesarean scar dehiscence (CSD) is an infrequent yet significant occurrence following lower segment cesarean section (LSCS) surgery. It is often linked to underlying uterine anomalies, such as a cesarean scar. This study aimed to assess the risk factors for scar ruptures during labor in patients with a previous history of cesarean section. Methods and Materials: This was a prospective observational cross-sectional study that was conducted in the Department of Obstetrics and Gynaecology in Dhaka Medical College Hospital, Dhaka, Bangladesh from November 2016 to April 2017. In total 25 women with a previous history of cesarean section with labor pain admitted to the mentioned hospital were enrolled in this study as the study subjects. All cases were selected by purposive sampling technique. Data were processed, analyzed and disseminated by using MS Office tools. Results: This study revealed that in about 24% of cases, the risk factor was a 'history of 1 previous LSCS with oxytocin infusion'. In 16% of cases, risk factors included 'previous 1 LSCS with misoprostol induction' or '1 LSCS with home trial of labor and VBAC attempt'. Additionally, 8% of cases had risk factors like '2 previous LSCS with misoprostol', 'grand multiparity with oxytocin use', or '2 previous LSCS with oxytocin for labor'. Conclusion: In this study, there is every possibility of finding mixed risk factors in case of scar rupture. The combination of misoprostol, oxytocin and previous LSCS claimed the highest rank among the risk factors that was subsequently followed by only previous LSCS.