Ruptured uterus outcome among the pregnant women admitted in a tertiary care centre
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20181401Keywords:
Maternal mortality, Rent repair, Subtotal hysterectomy rupture uterus, UterusAbstract
Background: Rupture of a previously unscarred uterus is usually a catastrophic event resulting in death of the baby and sometimes even maternal death from blood loss. Incidence of rupture uterus varies from 0.3/1000 to 7/1000 deliveries in India accounting for 5% to 10% of all maternal deaths. Hence, the present study was conducted to study the proportion of ruptured uterus among the antenatal women admitted, their associated clinical spectrum and maternal outcome.
Methods: A cross sectional study was carried out among 46 antenatal women presented with ruptured uterus in the department of Obstetrics and Gynaecology at N.S.C.B medical college and Hospital at Jabalpur, (M.P) during 1st August 2011 to 31st August 2012.
Results: The incidence of ruptured uterus was 1 in 118 (0.84%) of all hospital deliveries. Mostly, 18 (39.1%) patients were in 26 -30yrs of age. Maximum, 22 patients (47.83%) with ruptured uterus were in second gravidae. Most common site of scar rupture was lower uterine segment, observed in 42 (91.30%) patients. The most common form of management was rent repair done in 36 (78.26%) patients, followed by subtotal hysterectomy (STH) in 8 (17.39%) and total hysterectomy (TH) in 2(4.34%) patients. A perinatal mortality was seen in 38 (82.60 %) cases with 1 maternal death was observed.
Conclusions: Reducing the primary cesarean section rate and early diagnosis with active surgical management will go a long way in reducing the incidence of ruptured uterus and maternal and fetal mortality.
References
Saradhi Reddy PS, Pateel A. A Study of Rupture Uterus Maternal and Foetal Outcome. J Dent Med Sci.2016;15(6):26-9.
Hofmeyr GJ, Say L, Gülmezoglu AM. WHO systematic review of maternal mortality and morbidity: the prevalence of uterine rupture. BJOG: Int J Obstet Gynaecol. 2005;112(9):1221-8.
Guise JM, McDonagh MS, Osterweil P, Nygren P, Chan BK, Helfand M. Systematic review of the incidence and consequences of uterine rupture in women with previous caesarean section. BMJ. 2004;329(7456):19.
Fisk NM, Shweni PM. Labor outcome of juvenile primiparae in a population with a high incidence of contracted pelvis. Int J Gynaecol Obstet 1989;28(1):5-7.
Neilson JP, Lavender T, Quenby S, Wray S. Obstructed labour. Br Med Bull 2003;67(1):191-204.
Topuz S. Spontaneous uterine rupture at an unusual site due to placenta percreta in a 21-week twin pregnancy with previous caesarean section. Clin Exp Obstet Gynecol. 2004;31(3):239–41.
Sunitha K, Indira I, Suguna P. Clinical Study of Rupture Uterus - Assessment of Maternal and Fetal Outcome. J Dent Med Sci.2015;14(3):39-45.
Sahu M, Natasha HK and Mandpe P. Case analysis of complete uterine rupture in a tertiary health care center Int J Reprod Contracept Obstet Gynecol 2016 Dec;5(12):4401-4.
Sahu Latika A. 10-year analysis of uterine rupture at a teaching institution. J Obstet Gynaecol India. 2006; 56 (6):502-6.
Gaikwad R A, Chavan N N. Study of cases of rupture uterus in a tertiary institute and its maternal and perinatal outcome. Int J Reprod Contracept Obstet Gynecol.2017;6(9):4023-7.
Fofie CO, Baffoe P. A Two-Year Review of Uterine Rupture in a Regional Hospital. Ghana Med J. 2010; 44(3):98-102.
Mukasa PK, Kabakyenga J, Senkungu JK, Ngonzi J, Kyalimpa M, Roosmalen VJ. Uterine rupture in a teaching hospital in Mbarara, western Uganda, unmatched case-control study. Reprod Health.2013; 10(1):29.
Rizwan N, Abbasi RM, Uddin SF. Uterine rupture, frequency of cases and fetomaternal outcome. J Pak Med Assoc.2011;61(4):322-4.
Padhye SM: Rupture of the pregnant uterus: a 20 year review. Kathmandu Univ Med J. 2005;3(11):234-8.
Omole O, Attah,. Uterine rupture: risk factors and pregnancy outcome. Gynecol Obstetric.2011;1:1.
Ofir K, Sheiner E, Levy A, Katz M, Mazor M. Uterine rupture: differences between a scarred and an unscarred uterus. Am J Obstet Gynecol.2004;19: 425–9.
Rashmi, Radhakrisknan G, Vaid NB, Agarwal N. Rupture uterus--changing Indian scenario. J Indian Med Assoc.2001;99(11):634-7
AE Diab. Uterine rupture in Yemen. Saudi Med J.2005;26(2):264-9.
Ghadei R, Behera A. Uterine Rupture: A Two-Year Review at a Teaching Institution. Annals of Int Med Dent Res.2017;3(6):9-12
Turgut A, Ozler A, Evsen MS, Soydinc HE, Goruk NY, Karacor T. Uterine rupture revisited: Predisposing factors, clinical features, management and outcomes from a tertiary care center in Turkey. Pak J Med Sci.2013;29(3):753-7.
Martínez-Biarge M, García-Alix A, Garcia-Benasach F, Gaya F, Alarcón A, González A et al. Neonatal neurological morbidity associated with uterine rupture. J Perinat Med. 2008;36(6):467-554.
