RESUMO
OBJECTIVE: Our aim was to evaluate the subsequent obstetrical outcome and rate of uterine rupture following a caesarean section before 32 weeks of gestation. PATIENTS AND METHODS: A retrospective cohort study of 200 consecutive women with a prior caesarean section performed between 25 and 32 weeks were contacted by questionnaire or followed through medical charts to determine the subsequent mode of delivery. RESULTS: Two hundred caesarean section were performed between 25 and 32 weeks from January 1997 to March 2000. Thirty-nine patients (19.2%) were lost to follow-up. Seventy-one patients had a subsequent delivery. Thirty-two attempted vaginal birth and the success rate was 87.5%. Thirty-nine patients had a subsequent caesarean. One case of uterine rupture occurred before labour at 31 weeks (1.4%, % IC 95% [0.25; 7.56]). CONCLUSION: After a previous caesarean delivery before 32 weeks, a trial of labour may be proposed when obstetrical conditions are optimal. However, uterine rupture may occur prior to labor.
Assuntos
Cesárea , Ruptura Uterina/epidemiologia , Nascimento Vaginal Após Cesárea/efeitos adversos , Adulto , Estudos de Coortes , Feminino , Humanos , Gravidez , Resultado da Gravidez , Terceiro Trimestre da Gravidez , Estudos Retrospectivos , Fatores de RiscoRESUMO
Homozygous beta-thalassemia is a severe, transfusion dependent anaemia that also causes infertility. Preimplantation genetic diagnosis is possible. Very few pregnancies are reported among such patients. They have a very high obstetrical risk and a pluridisciplinary follow is necessary.