Uterine rupture: a preventable obstetric catastrophe
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20196012Keywords:
Cesarean section, Hysterectomy, Mortality, Uterine ruptureAbstract
Background: Maternal health has long been acknowledged to be the cornerstone in public health. The objective of this study was to determine the incidence, etiology, risk factors, complications, treatment strategies, maternal and fetal outcome associated with uterine rupture and to determine how to decrease the maternal morbidity and mortality pertaining to it, as it is indeed a preventable obstetric catastrophe!
Methods: This is a retrospective study which was carried out in our institute. Analysis of 45 cases of uterine rupture including scar dehiscence, registered/emergency, rupture occurring in the antepartum or intrapartum period, irrespective of previous vaginal or cesarean delivery was done between July 2017 to June 2019 out of 16,330 deliveries. None of the cases were excluded. Statistical analysis was done comparing the mortality in general population and study population and it was determined that it contributes to the maternal mortality significantly hence making it essential to promptly diagnose and treat the cases.
Results: The incidence of rupture of uterus is average 0.27% (1 in 362). Out of 45 cases 9 (20%) were registered, and 36 (80%) were referred patients. The 20-30 years age group is the most vulnerable. Scarred uterus undergoing rupture were 34 (75.55%) as compared to rupture in intact uterus which were 11 (24.44%). The commonest modality of treatment used is suturing of tear which was done in 34 (75.55%) followed by total hysterectomy. There were 2 maternal deaths giving maternal mortality rate of 4.44% and perinatal mortality occurred in 18 (40%) cases.
Conclusions: Uterine rupture is a dire emergency with a high incidence of maternal and fetal morbidity and mortality. Skilled attendance with accessible obstetric care, focused antenatal care, strict intrapartum monitoring and good surgical approach are key elements for the prevention and management of uterine rupture.
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