COMPLETE UTERINE RUPTURE: STILL A DREADFUL OBSTETRICAL EMERGENCY
Keywords:
Perinatal Mortality,, Cesarean Section, Hysterectomy, Polyhydramnios, Gestational Age, OxytocinAbstract
Background: Rupture of gravid uterus is a devastating life threatening obstetrical emergency which is preventable. It
is associated with major maternal and perinatal morbidity and mortality.
Objective: To determine the incidence, demographic characteristics, risk factors, treatment and feto-maternal outcomes
of uterine rupture at a tertiary care hospital of Mardan.
Material and Methods: This descriptive cross sectional study was done at Department of Gynaecology & Obstetrics,
Mardan Medical Complex, Mardan, Pakistan from February 2017 to July 2017 over a period of six months. All pregnant
women of any age, parity, gestational age or booking status with intra-operative diagnosis of complete uterine rupture
were included in the study. Those patients with small partial rents in uterus or dehiscence were excluded. Data was
entered in predesigned proforma and analyzed.
Results: Frequency of ruptured uterus in our institution was 10/1000 deliveries. Amongst the risk factors, the commonest
was history of induction and augmentation by an untrained nonmedical personnel in 25(55%), followed by history
of previous cesarean in 9(20%) and obstructed labor in 8(18%) cases. Grand multiparous women comprised 36(80%)
cases and most common age group was 30-39 years. Thirty nine(86.6%) women delivered at home and 40(88.8%)
were nonbooked. Twenty two(48.8%) underwent uterine repair and subtotal hysterectomy was performed in 13(28.8%)
cases. Thirty eight (84%) women recovered well. Fetal deaths were observed in 37(82%) cases and 6(13%) delivered
with low APGAR score.
Conclusion: The magnitude and adverse maternal and fetal outcomes of ruptured uterus were high in the study area.
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