• J Reprod Med · Sep 2014

    Association of Montevideo units with uterine rupture in women undergoing a trial of labor.

    • Lindsay Maggio, Joanna Forbes, Lorine L Carey, Haleh Sangi-Haghpeykar, and Christina Davidson.
    • J Reprod Med. 2014 Sep 1; 59 (9-10): 464-70.

    ObjectiveTo determine if an association exists between Montevideo units (MVUs) and uterine rupture in women undergoing trial of labor after cesarean (TOLAC).Study DesignA case-control study of women who underwent a TOLAC, comparing uterine rupture (n = 9) to successful vaginal birth after cesarean (VBAC) (n = 48) and failed TOLAC (n = 35). MVUs were calculated in 12 10-minute intervals prior to uterine rupture, cesarean delivery, or complete dilation in the VBAC group. MVUs were compared between groups by Wilcoxon rank sum test. The pattern of change of MVUs over time was examined by linear regression mixed models.ResultsThe MVUs were similar among all groups (medians ranged from 140-175 [VBAC], 145-190 [TOLAC], and 130-195 [ruptures]). The analysis of pattern of change in MVUs over time demonstrated no difference within the VBAC group (p = 0.22) or the failed TOLAC group (p = 0.87), or between groups (VBAC and rupture [p = 0.56], failed TOLAC and rupture [p = 0.37]). A post-hoc power analysis showed a mean difference of 50 MVUs (SD 45) between VBAC and rupture and 55 MVUs (SD 45) between failed TOLAC and rupture can be detected with a power of 80% at a significance of 0.05.ConclusionThere is no association between MVUs and uterine rupture in women undergoing a TOLAC.

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