Uterine rupture: A preventable morbidity

Abstract

Objective: The objective of our study is to identify the risk factors for rupture uterus, plan the preventive measures and emphasize on proper management. Methods: It is a retrospective cross sectional, observation study in a tertiary care referral hospital conducted as a part of research and audit during postgraduate training. The patients treated for rupture uterus between April 2013 to March 2014 were studied in a tertiary care centre. The clinical presentation, risk factors, intraoperative findings, treatment modalities, maternal foetal outcome, postoperative complications were studied and analysed. Results: There were 28 (0.43%) patients with rupture uterus during the study period. Most of the women who had rupture uterus were in the age group of 26-30 years (60%). Thirteen (46.2%) patients had previous antenatal visits (booked patients). The most common cause leading to uterine rupture was previous caesarean section (60.7%). Complete rupture of uterus was more common than incomplete rupture. The anterior wall of lower segment of uterus was the most common site of uterine rupture. Maternal mortality rate was 7.14% and perinatal mortality rate was 64.2% in the study group. The live birth rate was 35.8%. Conclusions: Uterine rupture still happens and remains a serious obstetric complication. It is mainly due to delay in referrals and poor health services in rural areas. Regular drills, simulation models, training programmes should be conducted for healthcare workers to identify and treat this life threatening complication. Timely referral to well equipped higher centres with proper details of the preceding events should be emphasized.

Keywords

• previous caesarean section
• hysterectomy
• perinatal mortality