Uterine Rupture in Pregnancy-One Year Experience

Abstract

Objective: To determine the frequency, risk factors, maternal and fetal morbidity and mortality in uterine rupture. Study Design: A cross-sectional study. Patients and Methods: The study was conducted in Department of Obstetrics and Gynaecology, Allied Hospital, Faisalabad (a tertiary care centre) from January 2010 to December 2010. All cases of ruptured uterus who where admitted with or who developed this complication in the hospital were included in the study. Results: The frequency of uterine rupture was (0.39%). Out of these, only 7 patients (18%) were booked. The main risk factor was scarred uterus in 30 cases (79%) and (21%) was in unscarred uterus. Amongst unscarred uterine rupture, risk factors were grand multiparity (9%), obstructed labour (5%), oxytocic agents (5%) and forceps delivery (2%). Repair of uterus was done successfullyin 29 cases (76%). Obstetrical hysterectomy was done in 9 cases (24%). There were two maternal deaths (5.2%) and 32 (84%) still births. Conclusion: This study showed high frequency of serious obstetrical problem which can lead to high fetomaternal mortality. The leading cause of uterine rupture was scarred uterus (cesarean scar). To prevent this serious complication from occurring, most important is assessment of risk factors for uterine rupture both antenatally and in intrapartum period and to counsel the patient properly. Improvements which could also be implemented include availability of transport facilities for the patients and training sessions for the staff in emergency.