{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T06:05:39Z","timestamp":1764137139379,"version":"3.46.0"},"reference-count":24,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"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":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to analyze the incidence, risk factors, clinical presentations, and maternal\u2010perinatal outcomes of complete uterine rupture at a major tertiary hospital in China over a decade.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single\u2010center retrospective cohort study of all women who delivered at our hospital, from March 2012 to February 2022. Cases of complete uterine rupture, defined as a full\u2010thickness tear of the uterine wall confirmed intraoperatively, were identified. Data on demographics, obstetric history, clinical manifestations, management, and outcomes were extracted and analyzed using descriptive statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 232,563 total deliveries, 38 cases of complete uterine rupture were confirmed, yielding an incidence of 0.016% (1.6 per 10,000 deliveries). The median maternal age was 31\u2009years (range, 23\u201338), and the median gestational age at rupture was 36\n                      <jats:sup>+4<\/jats:sup>\n                      weeks (range, 13\n                      <jats:sup>+6<\/jats:sup>\n                      \u201340\n                      <jats:sup>+6<\/jats:sup>\n                      ). A prior uterine scar was the predominant risk factor, present in 32 cases (84.2%), primarily from previous cesarean sections. Rupture occurred in unscarred uteri in 6 cases (15.8%). Clinical presentation was highly variable: acute abdominal pain was the most common symptom (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920, 52.6%), followed by vaginal bleeding (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098, 21.1%) and fetal heart rate abnormalities (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910, 26.3%). Notably, 8 patients (21.1%) were asymptomatic, with the rupture discovered incidentally during elective cesarean section. Maternal morbidity was significant, although all mothers survived; however, the perinatal mortality rate was high at 27.5% (11 of 40 fetuses\/newborns). Thirty\u2010seven (97.4%) patients underwent uterine repair, and one (2.6%) required a hysterectomy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A prior uterine scar is the leading risk factor for complete uterine rupture. However, the heterogeneous clinical presentation, including a significant proportion of asymptomatic cases, poses a major diagnostic challenge. A high index of suspicion is crucial for timely intervention to mitigate adverse maternal and perinatal outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70122","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:17:52Z","timestamp":1761783472000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence, Risk Factors, and Outcomes of Complete Uterine Rupture: A 10\u2010Year Single\u2010Center Retrospective Study"],"prefix":"10.1111","volume":"51","author":[{"given":"Zhexia","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology The Fourth Hospital of Shijiazhuang  Shijiazhuang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Fourth Hospital of Shijiazhuang  Shijiazhuang 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Shijiazhuang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tianhong","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Fourth Hospital of Shijiazhuang  Shijiazhuang China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,29]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15271"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2016.1219997"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2019.01.009"},{"issue":"1","key":"e_1_2_12_5_1","first-page":"S639","article-title":"A Two\u2010Year Analysis of Uterine Rupture in Pregnancy","volume":"30","author":"Islam A.","year":"2018","journal-title":"Journal of Ayub Medical College, Abbottabad: 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