624 Uterine rupture in women with a prior cesarean delivery: labor characteristics

Uterine rupture in women undergoing trial of labor after cesarean (TOLAC) has been associated with induction and length. Contemporary definitions normal progress, based on data collected by the Consortium Safe Labor depicted Zhang’s partogram, allow for longer duration, but excluded a uterine scar. Here, we present characteristics TOLACs complicated rupture, context contemporary management guidelines. This is an observational study all clinically significant ruptures TOLAC from 2009-2019 at single tertiary academic center. ICD9/10 code search was used to identify obstetric trauma and/or maternal morbidity, followed electronic chart review confirm diagnosis collect demographic, pregnancy, characteristics. For active phase or 2nd stage arrest, rate cervical change prior (1st rupture), complete dilation (2nd rupture) compared median 95th % partogram. There were 21 1128 (1.86%). Table 1 demonstrates pregnancy Most induced augmented (76% 9.5%, respectively). latent phase, similarly distributed. no prolonged second stage. However, beyond expected hourly 86.7% time, though within 95th% Zhang curve 46.7% cases (Figure 1). who experienced exposed oxytocin, and, when demonstrated than average change. guidelines allowing duration may not be appropriate patients TOLAC, particularly oxytocin administration.View Large Image Figure ViewerDownload Hi-res image Download (PPT)