{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T18:05:33Z","timestamp":1776276333615,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T00:00:00Z","timestamp":1682553600000},"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":["BJOG"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Analysis of atypical cases of uterine rupture, namely, uterine rupture occurring in unscarred, preterm or prelabour uteri.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Descriptive multi\u2010country population\u2010based study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Ten high\u2010income countries within the International Network of Obstetric Survey Systems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women with unscarred, preterm or prelabour ruptured uteri.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We merged prospectively collected individual patient data in ten population\u2010based studies of women with complete uterine rupture. In this analysis, we focused on women with uterine rupture of unscarred, preterm or prelabour ruptured uteri.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Incidence, women's characteristics, presentation and maternal and perinatal outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 357 atypical uterine ruptures in 3\u2009064\u2009923 women giving birth. Estimated incidence was 0.2 per 10\u2009000 women (95% CI 0.2\u20130.3) in the unscarred uteri, 0.5 (95% CI 0.5\u20130.6) in the preterm uteri, 0.7 (95% CI 0.6\u20130.8) in the prelabour uteri, and 0.5 (95% CI 0.4\u20130.5) in the group with no previous caesarean. Atypical uterine rupture resulted in peripartum hysterectomy in 66 women (18.5%, 95% CI 14.3\u201323.5%), three maternal deaths (0.84%, 95% CI 0.17\u20132.5%) and perinatal death in 62 infants (19.7%, 95% CI 15.1\u201325.3%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Uterine rupture in preterm, prelabour or unscarred uteri are extremely uncommon but were associated with severe maternal and perinatal outcome. We found a mix of risk factors in unscarred uteri, most preterm uterine ruptures occurred in caesarean\u2010scarred uteri and most prelabour uterine ruptures in \u2018otherwise\u2019 scarred uteri. This study may increase awareness among clinicians and raise suspicion of the possibility of uterine rupture under these less expected conditions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17517","type":"journal-article","created":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T06:11:32Z","timestamp":1682662292000},"page":"1493-1501","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Incidence and outcomes of uterine rupture in women with unscarred, preterm or prelabour uteri: data from the international network of obstetric survey systems"],"prefix":"10.1111","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7420-5020","authenticated-orcid":false,"given":"Griet","family":"Vandenberghe","sequence":"first","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Ghent University Hospital  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Vierin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Ghent University Hospital  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kitty","family":"Bloemenkamp","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Birth Centre Wilhelmina's Children's Hospital, Division Woman and Baby University Medical Centre Utrecht  Utrecht the\u00a0Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvia","family":"Berlage","sequence":"additional","affiliation":[{"name":"Centre for Quality and Management in Health Care Medical Association of Lower Saxony  Hannover Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lotte","family":"Colmorn","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Rigshospitalet University Hospital of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6561-3321","authenticated-orcid":false,"given":"Catherine","family":"Deneux\u2010Tharaux","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, Obstetrics Perinatal and Paediatric Epidemiology Research Team (EPOP\u00e9), Centre for Epidemiology and Statistics  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4607-2072","authenticated-orcid":false,"given":"Serena","family":"Donati","sequence":"additional","affiliation":[{"name":"National Centre for Disease Prevention and Health Promotion Istituto Superiore di Sanit\u00e0 (Italian National Institute of Health)  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"Department of Knowledge Brokers THL Finnish Institute for Health and Welfare  Helsinki Finland"},{"name":"Department of Molecular Medicine and Surgery Karolinska Institute  Stockholm Sweden"},{"name":"Academic Primary Health Care Centre  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1984-4575","authenticated-orcid":false,"given":"M.","family":"Knight","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Langhoff\u2010Roos","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Rigshospitalet University Hospital of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1652-8235","authenticated-orcid":false,"given":"Pelle G.","family":"Lindqvist","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Education Karolinska Institute  Stockholm Sweden"},{"name":"Department of Obstetrics and Gynaecology  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Maier","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Clinic Ottakring Vienna Healthcare Group  Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6746-3259","authenticated-orcid":false,"given":"Jos","family":"van Roosmalen","sequence":"additional","affiliation":[{"name":"Athena Institute VU University Amsterdam  Amsterdam the Netherlands"},{"name":"Department of Obstetrics Leiden University Medical Centre  Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joost","family":"Zwart","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Deventer Hospital  Deventer the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristien","family":"Roelens","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; 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