Uterine rupture: a five-year experience at a tertiary care centre in Jeddah, Saudi Arabia

Abstract

To determine the incidence, characteristics of patients and identified the risk factors, and maternal and fetal outcomes of uterine rupture at KAUH. Materials and Methods: Retrospective analysis of 51 cases of uterine ruptures (KAUH), from January 2011 to December 2015. Variables (age, gravidity, height, BMI, risk factors, previous C/S, previous abortion antepartum hemorrhage (APH), postpartum hemorrhage (PPH), gestational diabetes mellitus (GDM), smoking, multiple pregnancies, educational level >12 years, induction and method, mode of delivery, gender, fetal weight, neonatal NICU, and death and maternal outcomes. Ethical approval obtained. Inclusion criteria were all women admitted due to labor that had a ruptured uterus and managed at KAUH. Results: In a total of 20,568 deliveries, uterine rupture occurred in 51 cases (incidence of 0.03%, 1:403), scarred vs. unscarred was 1:514, and 1:1870, respectively. Age was 21 to 46 years, with a mean of 32.69 ± 5.59 years. There were two primigravida (3.9%), 27 multigravida (52.9%), and 22 grand multigravida (43.3%). Thirty-nine (76.5%) underwent emergency C/S, three (5.9%) delivered by spontaneous vaginal delivery, and 24 patients (47.1%) had received maximum eight units of packed red blood cells. One patient underwent a hysterectomy, and five women were admitted to the ICU. Hospitals stay was from three to nine days. Nine babies had Apgar score ≤ 6 at one minute, admission to NICU included nine (17.6%) babies. Neonatal death occurred in five (6.1%) babies. Conclusion: Incidence uterine rupture is low 0.03 % in the present institution. Scarred uterus ruptured more frequently than unscarred. Risk factors include age > 35 years, gravidity > 4, past history of C/S, level of education less than 12 years, and significant neonatal morbidity.