{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:40:39Z","timestamp":1787618439575,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T00:00:00Z","timestamp":1681862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the association between unintended uterine extension in cesarean delivery and uterine scar disruption (rupture or dehiscence) at the subsequent trial of labor after cesarean delivery (TOLAC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a multicenter retrospective cohort study (2005\u20132021). Parturients with a singleton pregnancy who had unintended lower\u2010segment uterine extension during the primary cesarean delivery (excluding T and J vertical extensions) were compared with patients who did not have an unintended uterine extension. We assessed the subsequent uterine scar disruption rate following the subsequent TOLAC and the rate of adverse maternal outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study period, 7199 patients underwent a trial of labor and were eligible for the study, of whom 1245 (17.3%) had a previous unintended uterine extension and 5954 (82.7%) did not. In univariate analysis, previous unintended uterine extension during the primary cesarean delivery was not significantly associated with uterine scar rupture in the following subsequent TOLAC. Nevertheless, it was associated with uterine scar dehiscence, higher rates of TOLAC failure, and a composite adverse maternal outcome. In multivariate analyses, only the association between previous unintended uterine extension and higher rates of TOLAC failure was confirmed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A history of unintended lower\u2010segment uterine extension is not associated with an increased risk for uterine scar disruption following subsequent TOLAC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.14785","type":"journal-article","created":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T15:05:02Z","timestamp":1681916702000},"page":"957-963","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Unintended lower\u2010segment hysterotomy extension at cesarean delivery and the risk for uterine rupture during a subsequent trial of labor"],"prefix":"10.1002","volume":"162","author":[{"given":"Tzuria","family":"Peled","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Shaare Zedek Medical Center affiliated with the Hebrew University School of Medicine  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eran","family":"Ashwal","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology McMaster University Medical Center, McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4063-5911","authenticated-orcid":false,"given":"Reut","family":"Rotem","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology McMaster University Medical Center, McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hen Y.","family":"Sela","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Shaare Zedek Medical Center affiliated with the Hebrew University School of Medicine  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sorina","family":"Grisaru\u2010Granovsky","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Shaare Zedek Medical Center affiliated with the Hebrew University School of Medicine  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misgav","family":"Rottenstreich","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Shaare Zedek Medical Center affiliated with the Hebrew University School of Medicine  Jerusalem Israel"},{"name":"Department of Nursing Jerusalem College of Technology  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,19]]},"reference":[{"issue":"8","key":"e_1_2_8_2_1","first-page":"1","article-title":"Births: final data for 2017","volume":"67","author":"Martin JA","year":"2018","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2011.03.011"},{"key":"e_1_2_8_4_1","unstructured":"Royal College of Obstetricians & Gynaecologists.Birth after previous caesarean birth (Green\u2010top Guideline No. 45).2007."},{"issue":"2","key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1097\/AOG.0b013e3181eeb251","article-title":"ACOG practice bulletin no. 115: vaginal birth after previous cesarean delivery","volume":"116","author":"ACOG","year":"2010","journal-title":"Obstet Gynecol"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.14154"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.03.013"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13798"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2020.1783230"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2014.08.025"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1676827"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.01.026"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.07.013"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1676112"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2016.1212010"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2018.1446421"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004234"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040405"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2007.11.008"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.47102\/annals-acadmedsg.2020319"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1739461"}],"container-title":["International Journal of Gynecology &amp; 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