Publication:

Retrospective study of cases of rupture uterus

Background This study aimed to evaluate the risk factors, clinical presentation, management, maternal and perinatal outcome of patients with rupture uterus.

Methods In this study, clinical records of 14 cases of rupture uterus occurring between January 2001 to August 2004 were reviewed.

Results During this period 17312 deliveries were conducted and 14 cases of rupture uterus were managed. Incidence of rupture uterus was 0,8/1000 deliveries. In 10/14 (71.4%) of cases, rupture occurred in scarred uterus (either of cesarean delivery or of any surgery).9/14 (64.2%) women had rupture of previous cesarean section scar and 4/14 (28.5%) women had rupture of unscarred uterus .7/14 (50%) women had more than one risk factor responsible for rupture uterus. 10/14 (71.4%) women were unbooked.10/14 (71.4%) women had subtotal hysterectomy; 4/14 (28.5%) had repair of scar site. Invariably blood had to be transfused in every case per and post-operatively.6/14 (42.8%) of fetuses could be salvaged; in 7/14 (50%) women; there was intrauterine death, while another (7.14%) woman had preterm neonatal death.

Conclusions Uterine rupture is a preventable complication. In our study, most of women had no antenatal check-up and/or managed initially by untrained personnel. Antenatal and intranatal care, identification of high-risk cases and education of the people about supervised pregnancy and delivery will reduce the occurrence of uterine rupture.