Unscarred uterine rupture: a retrospective analysis

Authors

  • Sirisha Paidi Department of Obstetrics and Gynecology, Andhra Medical College/King George Hospital, Visakhapatnam, Andhra Pradesh, India
  • Bhavani K. Department of Obstetrics and Gynecology, Andhra Medical College/King George Hospital, Visakhapatnam, Andhra Pradesh, India
  • Prasanthi P. S. Department of Obstetrics and Gynecology, Andhra Medical College/King George Hospital, Visakhapatnam, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20220738

Keywords:

Induction of labor, Instrumental delivery, Obstructed labor, Unscarred uterine rupture, Uterine rupture

Abstract

Uterine rupture is an obstetrical emergency associated with significant maternal and fetal mortality and morbidity. Spontaneous rupture of an unscarred uterus, though rare, can occur in developing countries. Many risk factors for uterine rupture, as well as a wide range of clinical presentations, have been identified. The aim of the study was to analyze the incidence, predisposing factors and to determine the maternal and perinatal outcomes of unscarred uterine rupture. A retrospective analysis of cases of unscarred uterine rupture was conducted at the department of obstetrics and gynecology, Andhra Medical College/King George Hospital, Visakhapatnam from 01 October 2020 to 31 October 2021. Out of the 8657 deliveries in our hospital during the study period, there were 11 cases of ruptured unscarred uteri giving an incidence of 0.127%. All of these (100%) were unbooked cases. Most of them (90.9%) were multigravida. Uterine rupture occurred at term in 9 cases and 2 were pre term. Maternal mortality was 18.18% (2 cases) and perinatal mortality was 72.72% (8 cases). Sub-total hysterectomy was done in 4 and laparotomy with repair of the rent was performed in the remaining 7 cases. Unscarred uterine rupture though a rare complication of pregnancy, can occur commonly in developing countries. Obstructed labour, mismanaged labour, injudicious use of oxytocin and grand multiparity are the common risk factors associated with unscarred uterine rupture.

Author Biographies

Bhavani K., Department of Obstetrics and Gynecology, Andhra Medical College/King George Hospital, Visakhapatnam, Andhra Pradesh, India

ASSITANT PROFESSOR

DEPARTMENT OF OBSTETRICS AND GYNECOLOGY

Prasanthi P. S., Department of Obstetrics and Gynecology, Andhra Medical College/King George Hospital, Visakhapatnam, Andhra Pradesh, India

POST GRADUATE STUDENT

DEPARTMENT OF OBSTETRICS AND GYNECOLOGY

References

Gibbins KJ, Weber T, Holmgren CM, Porter TF, Varner MW, Manuck TA. Maternal and fetal morbidity associated with uterine rupture of the unscarred uterus. Am J Obstet Gynecol. 2015;213(3):382-6.

Rizwan N, Abbasi RM, Uddin SF. Uterine rupture, frequency of cases and fetomaternal outcome. J Pak Med Assoc. 2011;61(4):322-4.

Akhtar Y. Ruptured uterus; an on-going tragedy of motherhood. Professional Med J. 2010;17(2):314-7.

Hofmeyr GJ, Say L, Gülmezoglu AM. WHO systematic review of maternal mortality and morbidity: the prevalence of uterine rupture. BJOG. 2005;112(9):1221-8.

Turner MJ. Uterine rupture. Best Pract Res Clin Obstet Gynaecol. 2002;16(1):69-79.

Mazzone ME, Woolever J. Uterine rupture in a patient with an unscarred uterus: a case study. WMJ. 2006;105(2):64-6.

Dow M, Wax JR, Pinette MG, Blackstone J, Cartin A. Third-trimester uterine rupture without previous cesarean: a case series and review of the literature. Am J Perinatol. 2009;26(10):739-44.

Miller DA, Goodwin TM, Gherman RB, Paul RH. Intrapartum rupture of the unscarred uterus. Obstet Gynecol. 1997;89(5):671-3.

Porreco RP, Clark SL, Belfort MA, Dildy GA, Meyers JA. The changing specter of uterine rupture. Am J Obstet Gynecol. 2009;200(3):269.

Rashmi, Radhakrisknan G, Vaid NB, Agarwal N. Rupture uterus--changing Indian scenario. J Indian Med Assoc. 2001;99(11):634-7.

Nahum GG, Pham KQ. Uterine rupture in pregnancy; 2011. Available at: http://reference.medscape. com/article. Accessed on 02 February 2022.

Ahmadi S, Nouira M, Bibi M, Boughuizane S, Saidi H, Chaib A, et al. Uterine rupture of the unscarred uterus. About 28 cases. Gynecol Obstet Fertil. 2003;31(9):713-7.

Chibber R, Saleh E, Fadhli R, Jassar W, Harmi J. Uterine rupture and subsequent pregnancy outcome--how safe is it? A 25-year study. J Matern Fetal Neonatal Med. 2010;23(5):421-4.

Lim AC, Kwee A, Bruinse HW. Pregnancy after uterine rupture: a report of 5 cases and a review of the literature. Obstet Gynecol Surv. 2005;60(9):613-7.

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Published

2022-03-25

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Case Series