Uterine rupture: review of cases from tertiary care centre in India

Authors

  • Sachin Paprikar Late Baliram Kashyap Memorial Government Medical College and Shaheed Mahendra Karma Memorial Hospital, Chhattisgarh, India http://orcid.org/0000-0002-3081-3948
  • Arpita Lagoo Late Baliram Kashyap Memorial Government Medical College and Shaheed Mahendra Karma Memorial Hospital, Chhattisgarh, India
  • Jyoti Lagoo Late Baliram Kashyap Memorial Government Medical College and Shaheed Mahendra Karma Memorial Hospital, Chhattisgarh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20222317

Keywords:

Uterine rupture, Maternal outcomes, Fetal outcomes

Abstract

Background: Uterine rupture is rare catastrophic complication associated with high incidence of maternal and perinatal morbidity and mortality. This study aimed at assessing the incidence of uterine rupture; maternal and fetal outcomes in cases of uterine rupture and factors associated with it.

Methods: This retrospective study was carried out in the department of obstetrics and gynaecology, Late Baliram Kashyap memorial government medical college and Shaheed Mahendra Karma memorial hospital, Bastar, Chhattisgarh, India. All the cases of rupture uterus, who were admitted with the diagnosis or who had rupture during their stay in our hospital during the study duration of July 2018 to March 2020 were included in our study- 37 cases.

Results: Out of 37 cases of ruptured uterus 8 rupture occurred in women with prior lower segment caesarean section (LSCS) and 29 occurred in women without prior LSCS. There were equal numbers of cases (17 cases each, 45.9%) in the age groups 25-30 years and 31 years and above. Incidence of rupture was highest in multiparous (3 and above). 70.3% of rupture were un-booked patients. 89.2% were referred from periphery. 86.5% of ruptures occurred at more than 37 weeks. 54% of rupture had of inter pregnancy interval of less than 24 months. Most common predisposing factor for uterine rupture in our study was obstructed labor. The most common site of rupture was found to be anterior surface of lower segment of uterus. Maternal morbidities seen include need for blood transfusion in 94.5% of cases. Among the maternal morbidities noted, severe anemia requiring blood transfusion was most commonly observed.

Conclusions: Rupture of the pregnant uterus should be looked as a preventable entity. All possible efforts to reduce the incidence and the resultant maternal morbidity and mortality due to uterine rupture should be undertaken.

Author Biographies

Sachin Paprikar, Late Baliram Kashyap Memorial Government Medical College and Shaheed Mahendra Karma Memorial Hospital, Chhattisgarh, India

Dr. Sachin Paprikar is a young obstetrician and gynaecologist. He is an Ex-Sr. Registrar & alumnus of Hinduhrudaysamrat Balasaheb Thackarey Medical College (HBTMC) - Dr. Rustom Narsi Cooper Municipal General Hospital, Juhu, Mumbai and Late Baliram Kashyap Memorial Government Medical College - Shaheed Mahendra Karma Memorial Hospital, Jagdalpur, CG.
He has been awarded Dr. Kamal S Jain Prize, Dr. L. M. Shah Prize, Dr. N A Purandare Prize, Dr. G. B Belvi Prize, Dr. Shradha Upasni Prize etc for his work.
He is editor of Journal of Obstetrics & Gynaecology: Reports and has authored chapters and research papers published in various textbooks and journals. He is also peer reviewer for various indexed journals.
He is co-founder of MediAce, National Level Research Conference for UG & PG medical students.
Correspondence: sachin.paprikar.nsk1@gmail.com

Arpita Lagoo, Late Baliram Kashyap Memorial Government Medical College and Shaheed Mahendra Karma Memorial Hospital, Chhattisgarh, India

Obstetrician & Gynecologist,
Assistant Professor, Late Baliram Kashyap Memorial Government Medical College & Shaheed Mahendra Karma Memorial Hospital, Jagdalpur, Chhattisgarh.
JLNHRC, Bhilai alumnus.

Jyoti Lagoo, Late Baliram Kashyap Memorial Government Medical College and Shaheed Mahendra Karma Memorial Hospital, Chhattisgarh, India

Obstetrician & Gynecologist,
Associate Professor, Late Baliram Kashyap Memorial Government Medical College & Shaheed Mahendra Karma Memorial Hospital, Jagdalpur, Chhattisgarh.
JLNHRC, Bhilai alumnus.

References

Uterine rupture in pregnancy: overview, rupture of the unscarred uterus, previous uterine myomectomy and uterine rupture. Available at: https://reference. medscape.com/article/275854-overview. Accessed on 20 October 2021.

William A. Obstetrics. 25th ed. United Sates of America: McGraw Hill; 2009.

Guiliano M, Closset E, Therby D, LeGoueff F, Deruelle P, Subtil D. Signs, symptoms and complications of complete and partial uterine ruptures during pregnancy and delivery. Eur J Obstet Gynecol Reprod Biol. 2014;179:130-4.

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

Uterine rupture: a seven-year review at a tertiary care hospital in New Delhi, India. Eur J Obstet Gynecol Reprod Biol. 2012;34:45-9.

Sharmin T, Mirza TT, Hasan MR, Sarker K, Shamsi S, Shikha SS, Panna LK. Clinical Study on Rupture Uterus in Mymensingh Medical College Hospital. Mymensingh Med J. 2019;28(3):520-6.

Hasan MR, Sarker K. Uterine rupture in pregnancy: a five-year study. Int J Reprod Contracept Obstet Gynecol. 2013;21:12-9.

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

Singh A, Shrivastava C. Uterine rupture: still a harsh reality. J Obstet Gynaecol India. 2015;65(3):158-61.

Desai A. Rupture uterus: a prospective observational study of 25 consecutive cases in a tertiary referral centre in South India. Int J Reprod Contracept Obstet Gynecol. 2014;12:23-9.

Sahu M, Mandpe P. Case analysis of complete uterine rupture in a tertiary health care center. Int J Reprod Contracept Obstet Gynecol. 2016;5(12):4401-4.

Ezechi OC, Mabayoje P, Obiesie LO. Ruptured uterus in South Western Nigeria: a reappraisal. Singapore Med J. 2004;45(3):113-6.

Sentilhes L, Vayssière C, Beucher G, Deneux-Tharaux C, Deruelle P, Diemunsch P, et al. Delivery for women with a previous cesarean: guidelines for clinical practice from the French college of gynecologists and obstetricians (CNGOF). Eur J Obstet Gynecol Reprod Biol. 2013;170(1):25-32.

Ameh C. Ruptured uterus in a tropical teaching hospital: choice of surgical treatment versus maternal outcome. J Turk Ger Gynecol Assoc Artemis. 2021;12:23-9.

Astatikie G, Limenih MA, Kebede M. Maternal and fetal outcomes of uterine rupture and factors associated with maternal death secondary to uterine rupture. BMC Preg Childbirth. 2017;17(1):117.

Chuni N. Analysis of uterine rupture in a tertiary center in Eastern Nepal: lessons for obstetric care. J Obstet Gynaecol Res. 2006;32(6):574-9.

Rashmi, Radhakrisknan G, Vaid NB, Agarwal N. Rupture uterus changing Indian scenario. J Indian Med Assoc. 2001;99(11):634-7.

Diab AE. Uterine ruptures in Yemen. Saudi Med J. 2005;26(2):264-9.

Downloads

Published

2022-08-29

Issue

Section

Original Research Articles