{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T16:53:49Z","timestamp":1790528029006,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,3,10]],"date-time":"2019-03-10T00:00:00Z","timestamp":1552176000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100006095","name":"South-Eastern Norway Regional Health Authority","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Complete uterine rupture, a rare peripartum complication, is often associated with a catastrophic outcome for both mother and child. However, few studies have investigated large datasets to evaluate maternal outcomes after complete ruptures, particularly in unscarred uteri. This paucity of studies is partly due to the rarity of both the event and the serious outcomes, such as peripartum hysterectomy and maternal death. The incidence of uterine rupture is expected to increase, due to increasing cesarean section rates worldwide. Thus, it is important to have more complete knowledge about the immediate maternal outcome following a complete uterine rupture. The objective was to identify maternal outcomes and their risk factors following complete uterine ruptures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This was a population\u2010based study using data from the Medical Birth Registry of Norway, the Patient Administration System and medical records. Maternities with complete uterine rupture after start of labor in Norway during 1967\u20102008 (n\u00a0=\u00a0247 births), identified among 2\u00a0209\u00a0506 women. Uterine ruptures were identified from both registries and were further studied through a review of medical records. Only complete ruptures were included in analysis. The associations between maternal outcomes and demographic and labor risk factors were estimated. Odds ratios (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>s) were determined with crude logistic regressions for each risk factor. Separate multivariable logistic regressions were performed to calculate adjusted odds ratios and 95% confidence intervals (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>s).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 88 (35.6%) healthy mothers, 107 (43.3%) severe postpartum hemorrhages without hysterectomy, 51 (20.6%) peripartum hysterectomies, and three (1.2%) maternal deaths. Peripartum hysterectomy decreased significantly in the last years of study. Unscarred uterine ruptures significantly increased the risk of peripartum hysterectomy compared with scarred uterine ruptures (<jats:styled-content style=\"fixed-case\">AOR<\/jats:styled-content> 2.6, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.3\u20105.3). Other factors that increased the risk of peripartum hysterectomy following rupture were: maternal age \u226535\u00a0years (<jats:styled-content style=\"fixed-case\">AOR<\/jats:styled-content> 2.3, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.1\u20105.0), parity \u22653 vs parity 1\u20102 (<jats:styled-content style=\"fixed-case\">AOR<\/jats:styled-content> 2.8, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.2\u20106.7), and rupture detection after vaginal delivery (<jats:styled-content style=\"fixed-case\">AOR<\/jats:styled-content> 2.2, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.1\u20104.8).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Unscarred uteri, older maternal age, parity \u22653, and rupture detection after vaginal delivery showed the highest associations with the risk of peripartum hysterectomy after complete uterine rupture.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13579","type":"journal-article","created":{"date-parts":[[2019,2,14]],"date-time":"2019-02-14T16:43:53Z","timestamp":1550162633000},"page":"1024-1031","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Maternal outcome after complete uterine rupture"],"prefix":"10.1111","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3943-5082","authenticated-orcid":false,"given":"Iqbal","family":"Al\u2010Zirqi","sequence":"first","affiliation":[{"name":"Norwegian National Advisory Unit on Women's Health Rikshospitalet Oslo University Hospital Oslo Norway"},{"name":"Women and Children's Division Rikshospitalet Oslo University Hospital Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Kjersti","family":"Daltveit","sequence":"additional","affiliation":[{"name":"Department of Global Public Health and Primary Care University of Bergen Bergen Norway"},{"name":"Medical Birth Registry of Norway Norwegian Institute of Public Health Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4681-4774","authenticated-orcid":false,"given":"Siri","family":"Vangen","sequence":"additional","affiliation":[{"name":"Norwegian National Advisory Unit on Women's Health Rikshospitalet Oslo University Hospital Oslo Norway"},{"name":"Institute of Clinical Medicine University of Oslo Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1067\/S0002-9378(03)01052-4"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2007.11.008"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2012.725790"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2009.02136.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(97)00073-2"},{"key":"e_1_2_9_7_1","first-page":"898","article-title":"Uterine rupture during pregnancy. An analysis of 133 patients","volume":"23","author":"Garnet JD","year":"1964","journal-title":"Obstet Gynecol"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.05.048"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.04.010"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02533.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.10.017"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13394"},{"key":"e_1_2_9_13_1","unstructured":"Directorate of Health and Social Services.The International Statistical Classification of Diseases and Related Health Problems ICD\u201010 10th revision. Used with permission from WHO.Oslo:Norwegian edition;2005."},{"key":"e_1_2_9_14_1","unstructured":"International Classification of Diseases ICD\u20108 8th revision (1965).2007.www.wolfbane.comicd\/icd8h.html. Accessed February 24 2014."},{"key":"e_1_2_9_15_1","unstructured":"International Classification of Diseases. ICD\u20109 9th revision (1979).2007.www.en.wikepedia.org\/wik\/List_of_ICD-9_codes. Accessed February 24 2014."},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12148"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2013.771165"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(93)90032-E"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15271"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2001.tb01283.x"},{"issue":"3","key":"e_1_2_9_21_1","first-page":"159","article-title":"Rupture of the uterus: a changing picture","volume":"240","author":"Van der Merwe JV","year":"1987","journal-title":"Arch Gynecol"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.4297\/najms.2011.358"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0161302"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.01.026"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/01674820400023408"},{"issue":"8","key":"e_1_2_9_26_1","first-page":"622","article-title":"Identifying risk factors for peripartum cesarean hysterectomy. A population\u2010based study","volume":"48","author":"Sheiner E","year":"2003","journal-title":"J Reprod Med"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faogs.13579","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.13579","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.13579","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.13579","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T07:25:42Z","timestamp":1694330742000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.13579"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,10]]},"references-count":25,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1111\/aogs.13579"],"URL":"https:\/\/doi.org\/10.1111\/aogs.13579","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,10]]},"assertion":[{"value":"2018-12-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}