Case analysis of complete uterine rupture in a tertiary health care center

Abstract

Background: To determine the incidence, etiology, risk factors, complications, treatment strategies, maternal and fetal outcome associated with complete rupture uterus.

Methods: This observational study was carried out in the Department of Obstetrics and Gynecology of Shriram Chandra Bhanj Medical College and Hospital, Cuttack, Odisha. The details of retrospective analysis of 52 cases of complete uterine rupture managed between July 2014 to April 2016 were reviewed.

Results: The incidence of uterine rupture was 1 in 353 deliveries (0.28%). Most of the patients (61.5%) presented belonged to age group of 26-30 years. The most common cause of rupture uterus was rupture of previous caesarean scar in 30 cases (57.64%), whereas cepahalopelvic disproportion was predisposing factor in 18 cases (34.61%) and malpresentation in 4 cases. In majority 80.76 % of lower uterine segment was involved. Bladder injury was seen in 4 cases (7.69%) A most common form of management was rent repair in 53.84% cases. There were 2 maternal deaths with perinatal mortality rate being 100% associated with complete uterine rupture.

Conclusions: Rupture of uterus is a dire emergency with high incidence of maternal and fetal mortality and morbidity. Most cases of rupture uterus are preventable with good antenatal and intrapartum care, and proper identification of high risk factors. Early diagnosis and active surgical management will go a long way in reducing the maternal and fetal mortality and morbidity.