Uterine rupture, frequency of cases and fetomaternal outcome

Objective: To determine the frequency, predisposing factors and maternal and foetal outcome of uterine rupture.Methods: This descriptive case series was conduced at the Department of Gynaecology and Obstetrics, Liaquat University of Medical Health Sciences, Jamshoro from January 2008 to December 2008.All cases of ruptured uterus, who were either admitted with this complication or who developed it in the hospital, were included in the study. Patients having ruptured uterus due to congenital abnormality were excluded from the study. Demographic data, details of predisposing factors, type of rupture, the management, maternal and foetal outcome were taken into consideration for analysis. Data was analyzed using SPSS version 10.0.Results: The total number of deliveries during the year January to December 2008 was 2010. There were 15 cases (0.74%) of uterine rupture. Out of these only three (20%) were booked. Most of the patients (60%) presented between the ages 26-30. Majority of uterine rupture occurred in para 2-4, (53.33%).Common cause of uterine rupture was prolonged neglected obstructed labour. Previous caesarean section scar was found in 41.66%. Anterior uterine wall was involved in 60% of cases. Rupture was complete in 73.33% of cases. Hysterectomy was performed in 53.33%. There were three maternal (20%) and 11 intrauterine deaths (73.33%). Live birth rate was 26.66%.Conclusion: This study showed that prolonged neglected obstructed labour is the main cause of uterine rupture followed by scarred uterus. Proper antenatal care and updated training programmes for health care providers is the need of time to prevent this catastrophic but avoidable complication.