Rupture uterus: a one year review to find out the causative factors

Authors

  • Beena Gupta Department of Obstetrics and Gynecology, Mata Gujri Memorial Medical College and Lions Seva Kendra Hospital, Kishanganj, Bihar, India
  • Prabhat Kumar Bhagat Department of Radiodiagnosis, Mata Gujri Memorial Medical College and Lions Seva Kendra Hospital, Kishanganj, Bihar, India
  • Rezaul Karim Department of Radiodiagnosis, Mata Gujri Memorial Medical College and Lions Seva Kendra Hospital, Kishanganj, Bihar, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20203304

Keywords:

Maternal mortality, Multipara, Rupture uterus, Uterine scar

Abstract

Background: Rupture uterus is a life-threatening obstetric emergency associated with high perinatal mortality. This study aims to find out the common factors associated with this catastrophic condition so as to help in decreasing the incidence of this condition in this study set-up. The objective of this study was to determine incidence, socio-demographic factors, etiology, types of presentation, patterns of management and maternal and fetal outcome in cases of rupture uterus presenting in this study hospital in one year.

Methods: In this retrospective study 40 cases of ruptured uterus admitted in the hospital between January to December 2016 were analyzed. Detailed history of relevant socio-demographic factors, prior obstetric and surgical history, clinical findings, nature of management done, fetal and maternal outcome were thoroughly analyzed from the record.

Results: A total 40 cases of ruptured uterus during this one-year period out of total 1220 deliveries constituted an incidence of 3%. The commonest age group is 25-30 years (47%). Majority of patients of rupture uterus were those with previous scarred uterus trying for vaginal delivery in hands of dais, untrained birth attendants and midwives. Repair was possible in the majority of cases. There were no maternal deaths but fetal mortality was 92.5%.

Conclusions: Proper antenatal care, transportation facilities, good counseling of patients with history of previous uterine surgery for institutional delivery can help in reducing the incidence of rupture uterus in developing countries like India. Prompt surgical intervention can help in reducing the maternal morbidity and mortality associated with rupture uterus.

References

Rajaram P, Agarwal A, Swain S. Determinants of maternal mortality: a hospital-based study from South India. Indian J Matern Child Health. 1995;6(1):7-10.

Cunningham F. In Obstetrical hemorrhageand prior caesarean delivery, Cunningham FG, Leveno KJ, Bloom SL, Spong CY et al (eds.), William’s Obstetrics, 24th ed, by McGraw-Hill Education; 2014;790-793: 609-20.

Cunningham FG, MacDonald PC, Gant NF. Obstetrical hemorrhage. Williams Obstetrics. Stamford Conn, Appleton and Lange, 20th ed; 1997: 772-778.

Malik HS. Frequency, predisposing factors and feto-maternal outcome in uterine rupture. J Coll Physicians Surg Pak. 2006;16:472-5.

Bashin A, Burstein E, Rosen S, Smolin A, Shiner E, Mazor M. Clinical Significance of uterine scar dehiscence in women with previous caesarean delivery: Prevalence and independent risk factors. J Reprod Med. 2008; 53:8-14.

Eden RD, Parker RT, Gall SA. Rupture of the pregnant uterus: a 53- year review. Obstet Gynecol. 1986;68(5):671-4.

Alam I, Khan A, Ahmed R, Begum N. A tow year review of uterine rupture at gynaecology unit-a ayub teaching hospital. J Ayub Med Coll Abottabad. 2000;12:21-2.

Omole-Ohonsi A, Attah R. Risk factors for ruptured uterus in a developing country. Gynecol Obstet. 2011;1(102):2161-0932.

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;191(2):425-9.

UNICEF. The state of the World’s Children Report Oxford University, Press New York; 1996.

WHO. Health status statistics: mortality. Geneva: World Health Organization; 2013.

Sunitha K, Indira I, Suguna P. Clinical study of rupture uterus - assessment of maternal and fetal outcome. IOSR-JDMS. 2015;14(3):39-45.

Khan S, Parveen Z, Begum S, Alam I. Uterine rupture: a review of 34 cases at Ayub Teaching Hospital Abbottabad. J Ayub Med Coll Abottabad. 2003;15:50-2.

Tayab S. Rupture of gravid uterus still an obstetrical problem. A three-year clinical analysis. J Coll Physician Surg Pak. 1996;6:144-7.

Mahbuba, Alam IP. Uterine rupture - experience of 30 cases at Faridpur Medical College Hospital. Faridpur Med Coll J. 2012;7(2):79-81.

Hamilton EF, Bujold E, McNamara H, Gauthier R, Platt RW. Dystocia among women with symptomatic uterine rupture. Am J Obstet Gynecol. 2001;184:620-4.

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;191(2):425-9.

Downloads

Published

2020-07-23

Issue

Section

Original Research Articles