Uterine Rupture - Experience of 30 Cases at Faridpur Medical College Hospital

Mahbuba,; Alam, Irin Parveen

doi:10.3329/fmcj.v7i2.13504

Cited by 15 publications

(18 citation statements)

References 2 publications

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“…A total of 15 women with unscarred uterus had rupture, of whom 14 women were trying to deliver at home with the help of traditional birth attendants. History of oxytocin induction was very common at 52.5 % [3,5,[7][8][9]. Oxytocics are easily available and often misused [8,10].…”

Section: Discussionmentioning

confidence: 99%

Uterine Rupture: Still a Harsh Reality!

Singh

Shrivastava

2014

J Obstet Gynecol India

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Objective To determine the, incidence, etiology, management, maternal, and fetal outcome and to evaluate trends in our area and recommend preventable measures. Methodology This prospective study is done between Jan 2012 and Aug 2013 in Pt. J.N.M. Medical College Raipur. All the women who had ruptured uterus were included. Relevant history was taken, women were assessed, adequate intervention done, and were followed up till 6 months after discharge. Result A total number of deliveries were 11,323. Out of 11,323 deliveries, 9,844 women were without prior LSCS, 1,479 women were with prior LSCS. A total of 40 cases of rupture uterus were there 25 in women with prior LSCS and 15 in women without LSCS. Thus, incidence among women with prior LSCS was 1.69 % and for women without LSCS was 0.152 %. Overall incidence of uterine rupture was 0.35 %. Major risk factors found were unbooked status (92.5 %), injudicious use of oxytocin (52.5 %), and unjustified VBAC trial (44 %). Bladder injury was found in 20 %. Extension to cervix was found commonly in uterus with no previous section (46.66 %). Blood transfusion was required in 92.5 %. Perinatal mortality was 85%. Only one maternal death was there (2.5%). Conclusion Developed countries have incidence of uterine rupture 0.000 % in women without LSCS and 1 % in women with prior LSCS [1]. Thus, by directly comparing, our study of 20 month revealed that women stand 1,500 times higher risk for rupture even without previous cesarean section and 1.7 times in women with previous section in comparison to the developed countries. The overall burden of women with previous section being admitted for 123 delivery is 12.28 %. 62.50 % women who had rupture uterus were those with previous section. Thus, careful selection of these women for trial of labor and a compulsory institutional delivery is recommended. We recommend use of oxytocin in titrated dose which clearly indicated by an obstetrician only, and it should be a prescription drug strictly.

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Section: Discussionmentioning

confidence: 99%

Uterine Rupture: Still a Harsh Reality!

Singh

Shrivastava

2014

J Obstet Gynecol India

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“…Incidence of ruptured uterus in the present study was 7.03/1000 deliveries (0.7% 12,13 Our hospital is a tertiary referral centre, with most of the cases being referred in an already moribund state. Studies conducted in developing countries also showed that in rural areas, low socioeconomic condition of the people and poor health facilities were the major contributing factor in determining the incidence of ruptured uterus.…”

Section: Discussionmentioning

confidence: 99%

Clinical study of cases of ruptured uterus in pregnancy

Vidyarthi

Kumari

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Rupture uterus is a rare and often catastrophic condition. It is associated with a high incidence of fetal and maternal morbidity and mortality. It is a preventable condition. Timely diagnosis and management results in better outcome. The objective of this study was to determine incidence, risk factor, management, maternal and fetal outcome in cases of uterine rupture.Methods: A retrospective study of cases of ruptured uterus was done over a period of one year from January 2015 to December 2015. The case sheets of patients were traced through labor room register, operation theatre register and medical record section.Results: There were 57 cases of ruptured uterus out of total 8112 deliveries in labor room, giving incidence of 7.03/1000 deliveries (0.7%). The most common risk factor was previous caesarean section in 59.7% of cases. In 54.4% cases patients were multiparous (≥3). Most of the patients presented with poor general condition, abdominal pain and tenderness, palpable fetal parts and in shock in 68.4% cases. Patients were treated with immediate resuscitation and laparotomy followed by either repair or hysterectomy. There was high perinatal mortality of 89.5%. Maternal mortality was 3.5%.Conclusions: Proper antenatal care, appropriate counselling of patients with history of previous caesarean section for hospital delivery, training of skilled birth attendant can reduce mortality and morbidity associated with rupture uterus.

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“…Incidence is 0.3/1000 to 7/1000 deliveries in India (1) and the perinatal mortality is as high as 74 to 94%. (2) According to WHO, incidence is 5.35 per 10000 live births. 0.8% after previous lower segment caesarean section, (3) >5% after classical caesarean section.…”

Section: B a C K G R O U N Dmentioning

confidence: 99%