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Poster Session 2

(491) Interpregnancy Interval and Uterine Rupture Risk in Women Undergoing Trial of Labor After Cesarean

Thursday, January 30, 2025
4:00 PM – 6:00 PM  
Objective: The interpregnancy interval (IPI) is the time between the end of one pregnancy and the start of the next. A short IPI, defined as 18 months or less, linked to negative outcomes like uterine rupture and preterm delivery. This study examines how the length of IPI affects the risk of uterine rupture and other major maternal and neonatal complications in women attempting a trial of labor after cesarean (TOLAC).

Study Design:

A retrospective cohort study was conducted at a single tertiary care center between 2010 and 2024. The study population included pregnant women with a history of one previous cesarean delivery (CD) who attempted a TOLAC. Participants were stratified based on interpregnancy interval (IPI) of less than or greater than 18 months. The primary outcome was the incidence of uterine rupture. Secondary outcomes encompassed other maternal and neonatal complications.

Results:

A total of 2386 women attempting TOLAC were included in the study, with 2151 (90.1%) in the IPI > 18 months group and 198 (9.9%) in the IPI < 18 months group. Baseline characteristics, including indication for previous CD, were comparable between the two groups (Table 1).

 

When attempting TOLAC, there was no significant difference in the incidence of uterine rupture between the two groups (0.5% vs. 0.8%, p=0.235; Table 2). Vaginal delivery rate was also similar between group, with failed TOLAC rate was ~38%. Other maternal and neonatal adverse outcomes did not differ significantly between the groups (Table 2).

Conclusion:

Our study found no association between short IPI and an increased risk of uterine rupture or other maternal and neonatal complications in women attempting TOLAC. These findings suggest that IPI may not be a strong predictor of adverse maternal or neonatal outcomes in women undergoing TOLAC. However, the small number of women in the short IPI group, limits the strength of these conclusions.  Further research with larger sample sizes is needed to confirm these findings and to explore other factors that may influence outcomes in this population.