DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20214339
Published: 2021-10-27

An observational study of uterine rupture at a tertiary care center

Sangeeta Tvinwal, Pooja Meena, Bharat Bhushan Bamaniya

Abstract


Background: Uterine rupture is one of the most dangerous obstetric emergency situation carrying an increased risk of maternal and perinatal morbidity and mortality. This catastrophic complication occurs most often in women attempting a vaginal birth after a prior LSCS. Aim was to determine the incidence, etiology, management, maternal and fetal outcome. Recommend strategy for its prevention to reduce the incidence of maternal and fetal morbidity and mortality.

Methods: This prospective observational study was conducted over a period of 1 year. Total 51 cases who were diagnosed with rupture were included in the study. Emergency laparotomy after pre-operative resuscitation done. Hysterectomy or repair of rupture site was done depending on the condition of the patient, parity, presence or absence of infection.

Results: Maximum patients of uterine rupture belonged to 37-40 weeks of GA. Inter-delivery interval <18-24 week were more vulnerable. Patients with previous caesarean section was more than without section. Maximum cases presented with signs of shock. Maternal death rate was 11.63%, whereas perinatal death rate was 82.35%.

Conclusions:Uterine rupture is a major contributor to maternal morbidity and neonatal mortality. Four major easily identifiable risk factors are: history of prior caesarean section, grand multiparity, obstructed labor, and fetal malpresentations. Identification of these high risk women, prompt diagnosis, immediate transfer, and optimal management needs to be overemphasized to avoid adverse feto-maternal complications.

 


Keywords


Fetal outcome, Maternal mortality, Scarred uterus, Uterine rupture

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References


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

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

Saini VK, Yadav PA, Munshi SP, Munshi DS, Marakaja NJ. Study of 30 cases of uterine rupture in teaching institution. Gujarat Med J. 2012;67(2):132-4.

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

Sinha M, Gupta R, Gupta P, Rani R, Kaur R, Singh R. Uterine rupture: a seven year review at a tertiary care hospital in New Delhi, India. Indian J Community Med. 2016;41:45-9.

Sunitha K, Indira I, Suguna P. Clinical study of rupture uterus- assessment of maternal and fetal outcome. IOSR J Dent Med Sci. 2015;14:39-45.

Desai R, Kamat AV. Rupture uterus: a prospective observational study of 25 consecutive cases in a tertiary referral centre in south India. Int J Reprod Contracept Obstet Gynecol. 2017;6:2601-6.

Fofie CO, Baffoe P. A two-year review of uterine rupture in a regional hospital. Ghana Med J. 2010;44:98-102.

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;10:29.

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

Padhye SM. Rupture of the pregnant uterus: a 20 year review. Kathmandu Univ Med J. 2005;3:234-8.

Omole-Ohonsi A. Uterine rupture: risk factors and pregnancy outcome. Gynecol Obstet. 2011;1(102):2161-0932.

Rathod S, Samal SK, Swain S. Rupture uterus: a 3-year clinical study. J Clin Diagn Res. 2015;9(11):qc04-6.

Sahu L. A 10-year analysis of uterine rupture at a teaching institution. J Obstet Gynaecol India. 2006;56(6):502-6.

Guise JM, Eden K, Emeis C. Vaginal birth after cesarean: new insights. Evid Rep Technol Assess (Full Rep). 2010;191:1-397.