Uterine rupture revisited: Predisposing factors, clinical features, management and outcomes from a tertiary care center in Turkey

Abstract

Objective: To determine the predisposing factors, modes of clinical presentation, management modalities and fetomaternal outcomes of uterine rupture cases at a tertiary care center in Turkey. Methodology: A 14-year retrospective analysis of 61 gravid (>20 weeks of gestation) uterine rupture cases between January 1998 to March 2012 was carried out. Results: The incidence of ruptured uteri was calculated to be 0.116%. Persistence for vaginal delivery after cesarean was the most common cause of uterine rupture (31.1%). Ablatio placenta was the most common co-existent obstetric pathology (4.9%). Bleeding was the main symptom at presentation (44.3%) and complete type of uterine rupture (93.4%) was more likely to occur. Isthmus was the most vulnerable part of uterus (39.3%) for rupture. The longer the interval between rupture and surgical intervention, the longer the duration of hospitalization was. Older patients with increased number of previous pregnancies were likely to have longer hospitalization periods. Conclusion: Rupture of gravid uterus brings about potentially hazardous risks. Regular antenatal care, hospital deliveries and vigilance during labor with quick referral to a well-equipped center may reduce the incidence of this condition.

Maternal and perinatal outcomes of rupture uterus at rural tertiary care institution: a retrospective study

“…A high index of suspicion and quick referral of all patients with previous cesarean sections to a well-equipped hospital with facility of surgery and blood can reduce the incidence of rupture. 15 Contrary to our study Anjali et al and Padhey reported more rupture in unscarred uterus 64.9% and 60% respectively as most of their patient had interventions with uterotonics. 6,9 Higher parity is another risk factor for uterine rupture particularly in spontaneous rupture and induction cases.…”

“…6 Turgut A et al had 34.4% cases with scar repair and total abdominal hysterectomy each, subtotal hysterectomy in his study was done in 31.1%. 15 Maternal mortality occurred in five cases (8.77%) which was more (3/5) in scarred uterus as compare to unscar one (2/5). Our perinatal mortality was 85.9%.…”

Ruptured uterus outcome among the pregnant women admitted in a tertiary care centre

“…Minor complications like febrile morbidity, urinary and respiratory infections and paralytic ileus were comparable to those in other studies. 20 In the present study only one maternal deaths was recorded. This could be because of the predominance of cesarean scar ruptures which were amenable to early diagnosis and repair.…”

Risk Factors and Outcomes of Placental Abruption: Evaluation of 53 Cases

“…The region where this study was conducted is known as a relatively low socioeconomic region. Again, delivery at home is common in this region due to insistence of persons on vaginal birth and even labor induction or augmentation at home is performed in a medically unconscientious way (14,15). As a result, persons may present to clinics with several obstetric complications such as ablation or uterine rupture (15).…”