Analyzing Influencing Factors of Uterine Rupture in Pregnant Women with Scarred Uterus Undergoing Repeat Delivery and Evaluating the Predictive Value of Lower Uterine Anterior Wall Thickness
Liying Zhang,1,* Ting Li,1,* Pengming Zhang,1 Chunjuan Li2 1Department of Ultrasound Medicine, Zhangjiakou First Hospital, Zhangjiakou, Hebei Province, 075000, People’s Republic of China; 2Department of Obstetrics and Gynecology, Chongli Hospital, Peking University Third Hosp...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2025-08-01
|
| Series: | International Journal of Women's Health |
| Subjects: | |
| Online Access: | https://www.dovepress.com/analyzing-influencing-factors-of-uterine-rupture-in-pregnant-women-wit-peer-reviewed-fulltext-article-IJWH |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849240036995760128 |
|---|---|
| author | Zhang L Li T Zhang P Li C |
| author_facet | Zhang L Li T Zhang P Li C |
| author_sort | Zhang L |
| collection | DOAJ |
| description | Liying Zhang,1,&ast; Ting Li,1,&ast; Pengming Zhang,1 Chunjuan Li2 1Department of Ultrasound Medicine, Zhangjiakou First Hospital, Zhangjiakou, Hebei Province, 075000, People’s Republic of China; 2Department of Obstetrics and Gynecology, Chongli Hospital, Peking University Third Hospital, Beijing, 076350, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ting Li, Email tgps643@163.comObjective: To analyze influencing factors of uterine rupture in pregnant women with a scarred uterus undergoing repeat delivery and to investigate the predictive value of transabdominal ultrasound measurement of lower uterine anterior wall thickness.Methods: A retrospective analysis of 159 pregnant women with scarred uterus (March 2022–May 2024) divided into rupture group (n=48) and non-rupture group (n=111). Lower uterine anterior wall thickness was measured via transabdominal ultrasound pre-delivery. Univariate/multivariate logistic regression and ROC curves were used to identify risk factors and evaluate predictive performance.Results: The rupture group had higher rates of advanced maternal age, prenatal BMI ≥ 30 kg/m², multiparity, single-layer cesarean suturing, and shorter inter-pregnancy intervals (all P< 0.05). Lower uterine anterior wall thickness was significantly thinner in the rupture group (1.24± 0.31 mm vs 2.19± 0.52 mm, P< 0.001). Multivariate analysis identified thinner lower uterine anterior wall thickness (OR=2.359, 95% CI:1.362– 4.134) and single-layer suturing (OR=1.863, 95% CI:1.125– 3.086) as independent risk factors, while longer inter-pregnancy interval was protective (OR=0.256, 95% CI:0.091– 0.634; all P< 0.05). ROC analysis showed AUCs of 0.821 (scar thickness), 0.783 (single-layer suturing), and 0.759 (inter-pregnancy interval); combined prediction achieved an AUC of 0.894 (95% CI:0.837– 0.946), sensitivity 90.23%, specificity 84.15%. Uterine rupture was associated with worse perioperative outcomes (eg, higher transfusion rates, longer hospitalization) and adverse neonatal outcomes (lower birth weight, more preterm births; all P< 0.05).Conclusion: Lower uterine anterior wall thickness, single-layer suturing, and inter-pregnancy interval are key determinants of uterine rupture. Combined assessment of these factors provides high predictive accuracy (AUC=0.894) and improves risk stratification.Keywords: lower uterine anterior wall thickness, scarred uterus, uterine rupture, risk factors, predictive value |
| format | Article |
| id | doaj-art-e01fbbfc726d417ab2c535fb35067b79 |
| institution | Kabale University |
| issn | 1179-1411 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of Women's Health |
| spelling | doaj-art-e01fbbfc726d417ab2c535fb35067b792025-08-20T04:00:44ZengDove Medical PressInternational Journal of Women's Health1179-14112025-08-01Volume 17Issue 124212431105443Analyzing Influencing Factors of Uterine Rupture in Pregnant Women with Scarred Uterus Undergoing Repeat Delivery and Evaluating the Predictive Value of Lower Uterine Anterior Wall ThicknessZhang L0Li T1Zhang P2Li C3Department of Ultrasound MedicineDepartment of Ultrasound MedicineDepartment of Ultrasound MedicineDepartment of Obstetrics and GynecologyLiying Zhang,1,&ast; Ting Li,1,&ast; Pengming Zhang,1 Chunjuan Li2 1Department of Ultrasound Medicine, Zhangjiakou First Hospital, Zhangjiakou, Hebei Province, 075000, People’s Republic of China; 2Department of Obstetrics and Gynecology, Chongli Hospital, Peking University Third Hospital, Beijing, 076350, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ting Li, Email tgps643@163.comObjective: To analyze influencing factors of uterine rupture in pregnant women with a scarred uterus undergoing repeat delivery and to investigate the predictive value of transabdominal ultrasound measurement of lower uterine anterior wall thickness.Methods: A retrospective analysis of 159 pregnant women with scarred uterus (March 2022–May 2024) divided into rupture group (n=48) and non-rupture group (n=111). Lower uterine anterior wall thickness was measured via transabdominal ultrasound pre-delivery. Univariate/multivariate logistic regression and ROC curves were used to identify risk factors and evaluate predictive performance.Results: The rupture group had higher rates of advanced maternal age, prenatal BMI ≥ 30 kg/m², multiparity, single-layer cesarean suturing, and shorter inter-pregnancy intervals (all P< 0.05). Lower uterine anterior wall thickness was significantly thinner in the rupture group (1.24± 0.31 mm vs 2.19± 0.52 mm, P< 0.001). Multivariate analysis identified thinner lower uterine anterior wall thickness (OR=2.359, 95% CI:1.362– 4.134) and single-layer suturing (OR=1.863, 95% CI:1.125– 3.086) as independent risk factors, while longer inter-pregnancy interval was protective (OR=0.256, 95% CI:0.091– 0.634; all P< 0.05). ROC analysis showed AUCs of 0.821 (scar thickness), 0.783 (single-layer suturing), and 0.759 (inter-pregnancy interval); combined prediction achieved an AUC of 0.894 (95% CI:0.837– 0.946), sensitivity 90.23%, specificity 84.15%. Uterine rupture was associated with worse perioperative outcomes (eg, higher transfusion rates, longer hospitalization) and adverse neonatal outcomes (lower birth weight, more preterm births; all P< 0.05).Conclusion: Lower uterine anterior wall thickness, single-layer suturing, and inter-pregnancy interval are key determinants of uterine rupture. Combined assessment of these factors provides high predictive accuracy (AUC=0.894) and improves risk stratification.Keywords: lower uterine anterior wall thickness, scarred uterus, uterine rupture, risk factors, predictive valuehttps://www.dovepress.com/analyzing-influencing-factors-of-uterine-rupture-in-pregnant-women-wit-peer-reviewed-fulltext-article-IJWHLower uterine anterior wall thicknessScarred uterusUterine ruptureRisk factorsPredictive value |
| spellingShingle | Zhang L Li T Zhang P Li C Analyzing Influencing Factors of Uterine Rupture in Pregnant Women with Scarred Uterus Undergoing Repeat Delivery and Evaluating the Predictive Value of Lower Uterine Anterior Wall Thickness International Journal of Women's Health Lower uterine anterior wall thickness Scarred uterus Uterine rupture Risk factors Predictive value |
| title | Analyzing Influencing Factors of Uterine Rupture in Pregnant Women with Scarred Uterus Undergoing Repeat Delivery and Evaluating the Predictive Value of Lower Uterine Anterior Wall Thickness |
| title_full | Analyzing Influencing Factors of Uterine Rupture in Pregnant Women with Scarred Uterus Undergoing Repeat Delivery and Evaluating the Predictive Value of Lower Uterine Anterior Wall Thickness |
| title_fullStr | Analyzing Influencing Factors of Uterine Rupture in Pregnant Women with Scarred Uterus Undergoing Repeat Delivery and Evaluating the Predictive Value of Lower Uterine Anterior Wall Thickness |
| title_full_unstemmed | Analyzing Influencing Factors of Uterine Rupture in Pregnant Women with Scarred Uterus Undergoing Repeat Delivery and Evaluating the Predictive Value of Lower Uterine Anterior Wall Thickness |
| title_short | Analyzing Influencing Factors of Uterine Rupture in Pregnant Women with Scarred Uterus Undergoing Repeat Delivery and Evaluating the Predictive Value of Lower Uterine Anterior Wall Thickness |
| title_sort | analyzing influencing factors of uterine rupture in pregnant women with scarred uterus undergoing repeat delivery and evaluating the predictive value of lower uterine anterior wall thickness |
| topic | Lower uterine anterior wall thickness Scarred uterus Uterine rupture Risk factors Predictive value |
| url | https://www.dovepress.com/analyzing-influencing-factors-of-uterine-rupture-in-pregnant-women-wit-peer-reviewed-fulltext-article-IJWH |
| work_keys_str_mv | AT zhangl analyzinginfluencingfactorsofuterineruptureinpregnantwomenwithscarreduterusundergoingrepeatdeliveryandevaluatingthepredictivevalueofloweruterineanteriorwallthickness AT lit analyzinginfluencingfactorsofuterineruptureinpregnantwomenwithscarreduterusundergoingrepeatdeliveryandevaluatingthepredictivevalueofloweruterineanteriorwallthickness AT zhangp analyzinginfluencingfactorsofuterineruptureinpregnantwomenwithscarreduterusundergoingrepeatdeliveryandevaluatingthepredictivevalueofloweruterineanteriorwallthickness AT lic analyzinginfluencingfactorsofuterineruptureinpregnantwomenwithscarreduterusundergoingrepeatdeliveryandevaluatingthepredictivevalueofloweruterineanteriorwallthickness |