Rate of uterine rupture during a trial of labor in women with one or two prior cesarean deliveries

Aaron B. Caughey, Thomas D. Shipp, John T. Repke, Carolyn M. Zelop, Amy Cohen, Ellice Lieberman

Research output: Contribution to journalArticlepeer-review

137 Scopus citations


OBJECTIVE: We sought to determine whether there is a difference in the rate of symptomatic uterine rupture after a trial of labor in women who have had 1 versus 2 prior cesarean deliveries. STUDY DESIGN: The medical records of all women with a history of either 1 or 2 prior cesarean deliveries who elected to undergo a trial of labor during a 12-year period (July 1984-June 1996) at the Brigham and Women's Hospital were reviewed. Rates of uterine rupture were compared for these 2 groups. Potential confounding variables were controlled by using logistic regression analyses. RESULTS: Women with 1 prior cesarean delivery (n = 3757) had a rate of uterine rupture of 0.8%, whereas women with 2 prior cesarean deliveries (n = 134) had a rate of uterine rupture of 3.7% (P= .001). In a logistic regression analysis that was controlled for maternal age, use of epidural analgesia, oxytocin induction, oxytocin augmentation, the use of prostaglandin E2 gel, birth weight, gestational age, type of prior hysterotomy, year of trial of labor, and prior vaginal delivery, the odds ratio for uterine rupture in those patients with 2 prior cesarean deliveries was 4.8 (95% confidence interval, 1.8-13.2). CONCLUSIONS: Women with a history of 2 prior cesarean deliveries have an almost 5-fold greater risk of uterine rupture than those with only 1 prior cesarean delivery.

Original languageEnglish (US)
Pages (from-to)872-876
Number of pages5
JournalAmerican journal of obstetrics and gynecology
Issue number4
StatePublished - Jan 1 1999
Externally publishedYes


  • Cesarean delivery
  • Trial of labor
  • Uterine rupture
  • Vaginal birth after cesarean delivery

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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