UTERINE RUPTURE IN SPONTANEOUS AND INDUCED LABOR AFTER CESAREAN SECTION: LITERATURE REVIEW AND ASSESSMENT OF RISKS
Aim: based on the data of recent publications to assess the risk of uterine rupture and success of the trial of labor after Cesarean in spontaneous and induced vaginal delivery in patients with a uterine scar. Material and methods. We reviewed and systematized the recent publications on the problem of operated uterine rupture and calculated the chances for successful trial of spontaneous and induced vaginal delivery, risks for its failure and uterine rupture. Results. The article presents the possibilities and safety of vaginal delivery in patients with the operated uterus. It was found out that in modern conditions the uterine rupture occurs in 1,0-2,3 % of cases, the rate of successful vaginal birth after Cesarean section is 69,3-73,2 %. Conclusion. The research showed that the rupture of the operated uterus during vaginal delivery is possible in 0,00006-0,00036 cases, the chances for successful vaginal delivery in patients with uterine scars are 4,47-5,02. Spontaneous labor in women with the operated uterus has a statistically higher risk of failure in natural maternal passages (p < 0,0001), but paired with a significantly lower risk for uterine rupture (p < 0,0001).