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Relative Risks of Uterine Rupture

Practice Variation in Cesarean Rates: Not Due to Maternal Complications
This brief but well-referenced post analyzes cesarean rates relative to differences in maternal diagnoses or pregnancy complexity. On average, the likelihood of cesarean delivery for an individual woman varied between 19 and 48 percent across hospitals.”

Birth attendants often claim that their high cesarean rate is due to their clientele - that they provide care for a lot of high-risk clients.  This analysis shows that:

    Among lower risk women, likelihood of cesarean delivery varied between 8 and 32 percent across hospitals.
    Among higher risk women, likelihood of cesarean delivery varied between 56 and 92 percent across hospitals.
    Hospital variability did not decrease after adjusting for patient diagnoses, socio-demographics, and hospital characteristics.

This shows that practice variation in cesarean rates is real, substantive, and not just a reflection of the mother’s risk level.

Tips for Choosing a Care Provider - great overview! from Henci Goer

Written by Eileen Sullivan, with assistance from her husband, Patrick.

After checking, it seems I was a bit off on the frequency of deadly lightning strikes... you are more likely to suffer a rupture than to be struck and killed by lightning, by about thirty times.  Then again, how many people do you know who HAVE been struck and killed by lightning? <s>

Ruptures are also more common than dying in a plane crash.  Henci Goer's review of the literature on VBACs found 46 ruptures in 15,154 labors.  This equates to a 0.3% rate... or 1 in 333, if you prefer. Your annual risk of dying in a plane crash is 1 in 4000, according to one source, and 1 in 700,000 according to another.  I can't explain the massive discrepancy between the two figures, except to quote Mark Twain about "lies, damn lies, and statistics."

Since you asked, here are some more probability statistics for you:

Your risk of dying in a car accident, over the course of your lifetime, is between 1 in 42 and 1 in 75.  This is roughly 4 to 5 times greater than the risk of uterine rupture.

You're about twice as likely to have your car stolen (that's an annual risk) than to experience a uterine rupture.

Your odds of being murdered are 1 in 140 over the course of your lifetime.  That's 2 times more likely than the risk of rupture.

The annual risk of having a heart attack is 1 in 160, 2 times more likely than rupture.  Your risk of dying from heart disease is roughly 1 in 6, or 55 times greater than your risk of rupture.

If you're a smoker, your risk of dying from lung cancer is 1 and a half times more likely than a VBAC mom rupturing during her labor.

You're about 17 times more likely to contract an STD this year than you are to have a uterine rupture; more likely to contract gonorrhea than to rupture, as well.

You're 13 times more likely to get food poisoning than to rupture.

You're more likely to have twins than a uterine rupture.  Odds of twins:  1 in 90.  That's about 3 1/2 times the likelihood of rupture.

If you ride horseback, you're 3 times more likely to die in a riding accident than you are to experience a uterine rupture.

If you ride a bike on the street, you are 4 times more likely to die in an accident (annual risk) than you are to suffer a rupture.

Having a serious fire in your home during the next year is twice as likely as experiencing a rupture.

You're ten times as likely to win at roulette as you are to have a uterine rupture.

If you flip a coin, you'll be more likely to get heads (or tails) 8 times in a row than to rupture.

The risk of cord prolapse is 1 in 37 (2.7%), or nearly ten times more likely than that of rupture.

And a final irony (heads up, those of you who want a doc to give his/her opinion on your likelihood of rupture next pregnancy!)...

You're 6 times more likely to have a doctor who is an impostor than you are to suffer a rupture.  Two percent of docs are phonies (1 in 50), according to several sources I found.

So instead of worrying about rupture, why not take a few minutes to check up on your doctor's credentials? ;)  It'd be a more profitable use of your time, and a substantially more likely cause for alarm.



This Web page is referenced from another page containing related information about ICAN/VBAC/Cesarean

 




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