Determinants of rupture of the unscarred uterus and the related feto-maternal outcome: current scenario in a low-income country

Batra, Kanika; Gaikwad, Harsha; Gutgutia, Isha; Prateek, Shashi; Bajaj, Bindu

doi:10.1177/0049475515598464

Cited by 8 publications

(9 citation statements)

References 4 publications

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“…The URIDA data analysis showed that UR is associated with previous uterine surgery. However, the present study's results agree with previous literature, 7 showing that UR can also occur in patients without previous uterine surgery. Even though associated with previous uterine surgery, the incidence did not increase with an increasing number of previous uterine operations, or if more than one type of operation was performed.…”

Section: Discussionsupporting

confidence: 92%

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Uterine rupture during pregnancy: The URIDA (uterine rupture international data acquisition) study

Tinelli

Kosmas

Carugno

et al. 2021

Intl J Gynecology & Obste

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Objective To describe the characteristics and peripartum outcomes of patients diagnosed with uterine rupture (UR) by an observational cohort retrospective study on 270 patients. Methods Demographic information, surgical history, symptoms, and postoperative outcome of women and neonates after UR were collected in a large database. The statistical analysis searched for correlation between UR, previous uterine interventions, fibroids, and the successive perinatal outcomes in women with previous UR. Results Uterine rupture was significantly associated with previous uterine surgery, occurring, on average, at 36 weeks of pregnancy in women also without previous uterine surgery. UR did not rise exponentially with an increasing number of uterine operations. Fibroids were related to UR. The earliest UR occurred at 159 days after hysteroscopic myomectomy, followed by laparoscopic myomectomy (251 days) and laparotomic myomectomy (253 days). Fertility preservation was feasible in several women. Gestational age and birth weight seemed not to be affected in the subsequent pregnancy. Conclusion Data analysis showed that previous laparoscopic and abdominal myomectomies were associated with UR in pregnancy, and hysteroscopic myomectomy was associated at earlier gestational ages. UR did not increase exponentially with an increasing number of previous scars. UR should not be considered a contraindication to future pregnancies.

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Section: Discussionsupporting

confidence: 92%

“…(5) the impact of fibroids on UR; (6) symptoms of UR; (7) length of hospitalization after UR; (8) complications of UR; (9) subsequent reproductive performance after UR, including fertility and the outcome of the following pregnancy; and (10) Apgar scores of the infant. This investigation was retrospective and not financially sponsored.…”

Section: Introductionmentioning

confidence: 99%

Uterine rupture during pregnancy: The URIDA (uterine rupture international data acquisition) study

Tinelli

Kosmas

Carugno

et al. 2021

Intl J Gynecology & Obste

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“…Uterine repair without tubal ligation was performed in only 5 women desiring future fertility. The percentage is much lower than 33.3% recorded in a study by Kankika et al but comparable with 5.9% in a study by Ahmed et al [28,31].…”

Section: Plos Onesupporting

confidence: 59%

Ruptured uterus: Frequency, risk factors and feto-maternal outcome: Current scenario in a low-resource setup

Abrar

Sayyed

et al. 2022

PLoS ONE

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Introduction Pakistan is among the countries with the highest maternal death rates. Obstetric hemorrhage accounts for 41% of these deaths. Uterine rupture is a grave obstetric emergency with high maternal and neonatal morbidity and mortality. It is important to identify its frequency and associated risk factors to formulate programs for its prevention and management. This study aimed to assess the frequency, associated risk factors, fetomaternal outcomes, and management of women with the ruptured uterus at our hospital. Material and methods It was a retrospective study of 206 women to review data collected from cases of uterine rupture managed at the WCTH Bannu, Pakistan from October 2016 to October 2018. A structured proforma was designed and used to extract data from operating theatre registers and the hospital medical records. In our hospital, there is a strong system of maintaining all information of the patients related to demographics, obstetric information, operative notes, and postoperative course during their hospital stay in the patient’s charts. Detailed information on operative procedures is further maintained in the operation theater register and all these registers are checked in the weekly statistical meetings to ensure proper documentation. Data was entered and analyzed in SPSS package version 21 (IBM Corp.; Armonk, NY, USA). Frequency and percentages were calculated for the categorical variables. For inferential statistics, chi-square or Fischer exact tests were used. A p-value of < 0.05 was considered statistically significant. Results The overall incidence of the ruptured uterus was 1.71%. The important etiological factors were grand multiparity 62 (35.2%), obstructed/neglected labour 58 (32.9%), injudicious use of Oxytocin 56 (31.8%) and prostaglandins 26 (14.7%), previous cesarean section 35 (19.8%) and previous pelvic surgery (0.5%). Hysterectomy was done in 80.6% of cases, 34 (19.2%) patients underwent uterine repair and 4.5% had bladder repair. The mortality rate was 21%, mainly due to irreversible shock or disseminated intravascular coagulation. Perinatal mortality was 91.4%. Duration of surgery more than two hours and presentation to the hospital at night time was significantly associated with poor maternal outcome (p = 0.00). Conclusion Uterine rupture is a preventable obstetric emergency associated with high fetomaternal morbidity and mortality. The main causes were grand multigravidity, obstructed labour, previous C-sections and injudicious use of oxytocin and prostaglandins. Women with prolonged surgery and admission at night time had a poor maternal outcome.

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“…15 Whereas case reported by Yi-Hui Lin et al in 2003 had a laceration about 1 cm in length over the left cornu. 19 Our case of posterior rupture of unscarred uterus is a very rare event and there has been hardly any case reported so far.…”

Section: Discussionmentioning

confidence: 89%

“…One study by Kanika Batra and et al in 2010-2012 shows there is 16.6% risk of rupture of uterus with labour induction. 19 Thus while augmenting labour in a patient we should always keep this catashtroph as complication in our mind even if the patient has no history of previous cesarean secton or mayomectomy.…”

Section: Discussionmentioning

confidence: 99%

A rare case of spontaneous posterior wall rupture in an unscarred uterus during labour

Nanda

Singh

Dhama

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Uterine rupture is a dreaded catastroph in obstetrics with a high incidence of maternal and fetal morbidity. In developing Country, the overall prevalence widely varies from 1 in 2,000 to 1 in 200 deliveries. Uterine rupture in an unscarred uterus is a rare event and only a finger countable cased have been reported on posterior rupture of uterus in unscarred uterus. We here presenting a case of spontaneous posterior rupture of an unscarred uterus. Our patient was 38 years old grand multipara, a 6th gravida female with 4 parity, 1 abortion last year and 3 live issues. She was 9 months of gestation with previous all normal vaginal deliveries. This time she had a uterine rupture in the lower segment of posterior wall of uterus during labour. The rupture was unrepeatable, so we have to do hysterectomy. This case points out to keep this catastroph in mind in multiparas with unscarred uterus and to be prepared for the same while assisting a normal vaginal delivery.

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Determinants of rupture of the unscarred uterus and the related feto-maternal outcome: current scenario in a low-income country

Cited by 8 publications

References 4 publications

Uterine rupture during pregnancy: The URIDA (uterine rupture international data acquisition) study

Uterine rupture during pregnancy: The URIDA (uterine rupture international data acquisition) study

Ruptured uterus: Frequency, risk factors and feto-maternal outcome: Current scenario in a low-resource setup

A rare case of spontaneous posterior wall rupture in an unscarred uterus during labour

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