Study the cases of rupture uterus in a tertiary care teaching hospital, Jharkhand, India and its maternal and perinatal outcome

Abstract

Background: Rupture of a pregnant uterus is a serious obstetric emergency and a common cause of maternal death. Study was done to evaluate the incidence, risk factors, management, maternal and fetal outcome of rupture uterus at RIMS.Methods: The present study was carried out in 80 cases of rupture uterus admitted in labour room in the department of Obstetrics and Gynaecology, RIMS, Ranchi, India from March 2014 to September 2015.Results: It was observed that the incidence rate of 0.763%. About 53.75% of ruptures of uterus were noted after 38 weeks of pregnancy. The cause of rupture uterus during labour in most of the cases was spontaneous (49.34%). scar rupture was the next frequent cause (45.33%) and traumatic rupture were 5.33%. Malpresentation and malposition contributed the most important aetiological factors causing spontaneous rupture during labour (43.24%). Hysterectomy was performed in 53.75% (subtotal, 32 cases i.e. 40% and total, 11 cases i.e. 13.75%).Conclusions: Rupture uterus is a serious and life threatening complication for both mother and the fetus. The leading cause of uterine rupture was found to be neglected and obstructed labor due to mismanagement by local untrained birth attendants. Timely recognition and referral to higher centers can reduce the maternal and fetal morbidity and mortality due to uterine rupture. Education and proper care especially of high risk patients like previous caesarean by competent personnel, proper use of oxytocin and early referral may help to reduce the incidence of rupture uterus.

Epidemiological profile, maternal and neonatal issue of uterine rupture at the Befelatanana Obstetrics and Gynecology University Hospital

“…These incomplete uterine ruptures are often better prognosis; Beck found a frequency of 96.25% complete uterine rupture with 97.5% fetal loss rate. 1,18 In contrast, Zeteroglu and al found only 65% complete uterine rupture. In this same study, the fetal mortality rate was 28.6% for incomplete form versus 38.5% for complete rupture.…”

“…For some authors, hysterectomy was the main treatment. 17,18 In Ethiopia, hysterectomy was performed in 75% of the cases. Among the patients, 38% were in hypovolemic shock.…”