Unscarred uterine rupture: a retrospective study
Keywords:Uterine rupture, Mortality, Hysterectomy
Background: Uterine rupture is a catastrophic obstetrical emergency associated with significant feto-maternal morbidity and mortality. Many risk factors have been identified, as well as wide range of clinical presentations. The objective of the study was to analyse the incidence and predisposing factors of unscarred uterine rupture and to determine maternal and fetal outcome.
Methods: Retrospective analysis of unscarred uterine rupture cases was conducted at the Department of Obstetrics and Gynecology, RIMS, Imphal from June 2012 to June 2014.
Results: Our case series comprised of 13 cases with unscarred uterine rupture incidence of 0.057%. Out of these, 69.2% were unbooked cases. Majority of the cases were para 2-3. Most of the rupture (76.9%) occurred during 2nd stage of labour. The lower segment uterine rupture was the most common site of rupture (30.8%) Maternal and perinatal mortality were 30.8% and 53.8%, respectively. Sub-total hysterectomy done in 87.5% cases.Conclusions: Rupture uterus is a high risk category of patients. An unscarred uterus can undergo rupture even without risk factors. The patients with mismanaged labour, grand multiparas and obstructed prolonged labour must be managed by proper trained personnel and in tertiary care centre in order to avoid the morbidity or mortality.
Rizwan N, Abbasi RM. Uterine rupture, frequency of cases and fetomaternal outcome. JPMA. 2011;61:322.
Akhtar Y. Ruptured uterus; an on-going tragedy of motherhood. Professional Med J. 2010; 17(2): 314-7.
Turner MJ. Uterine rupture. Best Pract Res Clin Obstet Gynaecol. 2012;16(1):69-79.
Walsh CA, Baxi LV. Rupture of the pimigravid uterus: a review of the literature. Obstet Gynaecol Surv. 2007;62(5):327-34.
WHO systematic review of maternal mortality and morbidity: the prevalence of uterine rupture. BJOG. 2005;112:1221-8.
Mazzone ME, Woolever J. Uterine rupture in a patient with an unscarred uterus: a case study. WMJ. 2006;105(2):64-6.
Dow M, Wax JR, Pinette MG, Blackstone J, Cartin A. Am J perinatal. 2009;26(10):739-44.
Miller DA, Goodwin TM, Gherman RB, Paul RH. Intrapartum rupture of the unscarred uterus. 1997;89(5):671-3.
Nahum G. Uterine rupture in pregnancy. Medline. 2010;10.
Ahmadi S, Nouira M, Bibi M. Uterine rupture of the unscarred uterus. About 28 cases. Gynecol Obstet Fertil. 2003;31(9):713-7.
Dane B, Dane C. Maternal death after uterine rupture in an unscarred uterus: a case report. J Emerg Med. 2009;37(4):393-5.
Rashmi, Radhakrishnan G, Vaid NB, Agarwal N. Rupture uterus- changing Indian scenario. J Indian Med Assoc. 2001;99(11):634-7.
Aboyeji AP, Ijaiya MD, yahaya UR. Ruptured uterus: a study of 100 consecutive cases in Ilorin, Nigeria. J Obstet Gynaecol Res. 2001;27(6):341-8.