Publication:

Retrospective study of cases of rupture uterus at tertiary care center in Egypt

Background Uterine rupture (UR)is one of the most serious obstetrical emergencies necessitating prompt diagnosis and management, as it en-dangers the maternal and fetal life. Uterine rupture (scarred/ unscarred) may occur at any stage of pregnancy. In developed countries, with good antenatal care and good supervision during labour, (UR) has become rare except by dehiscence of a caesarean scar. The objective of present study was to find out risk factors, management, related complications and associated maternal and fetal outcomes with rupture uterus.

Methods A retrospective study, data files and the case notes was retrieved from the medical records department at Aswan university hospital from January 1 2013 to December 31 2013 in the form of data relating to the age, parity, gestational age, method of termination, perinatal outcomes, and related maternal complications.

Results There were 4284 deliveries during the period under review among them 5 cases of uterine rupture. Thus, the incidence of uterine rupture was 1.1/1000 deliveries.3 cases (60%) of them had no antenatal care at any hospital or primary care center. The risk factors in these cases are in majority 4 (80%) of cases uterine rupture occurred in women with previous scar, 1case (20%) of cases uterine rupture occurred in women with none scarred uterus. As regard surgical management 3 cases (60%) managed by hysterectomy and 2cases (40%) managed by repair. As regard maternal and fetal outcome all women required blood transfusion. Associated bladder rupture was repaired in two cases (40%). After excluding fetal wastage before the age of viability, perinatal mortality was 100% (5/5).

Conclusions Present retrospective analytical study has concluded that rupture uterus is a life-threatening complication. Proper antenatal and intrapartum care, identification of high risk factors, promotion of skilled attendance at birth and institutional delivery are key factors in reduction and early diagnosis.