Uterine rupture at Lagos University Teaching Hospital

Abstract

Background: Uterine rupture remains a major life-threatening obstetric disaster encountered in many developing countries and is associated with a high maternal and perinatal mortality and morbidity. Objectives: The objective of this study was to determine the incidence, associated risk factors, trend, clinical presentation, management as well as maternal and fetal outcome of uterine rupture at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. Materials and Methods: This was a retrospective study of patients with uterine rupture at the LUTH, Idi-Araba, Lagos, Nigeria, from June 1, 2005 to May 31, 2013. The case records of patients in this period were retrieved from the medical health records department. The relevant data of sociodemographic characteristics, clinical presentation, management as well as maternal and perinatal outcome were collated using a structured questionnaire. Results: Of the 13,138 deliveries during the study period, there were eighty cases of uterine rupture giving a hospital incidence of 6.1/1000 deliveries. Patients with parities of 1 (28.36%) and 2 (38.81%) were identified to be at higher risk of uterine rupture. Previous caesarean section (46.28%), obstructed labor (26.87%), and injudicious use of oxytocin (16.42%) were the common associated factors. Rupture along previous anterior scar was the most common site affected in 32.84%; repair with bilateral tubal ligation was the surgical procedure in most of the cases (47.76%). The case fatality rate for ruptured uterus was 11.94% for the mothers and the perinatal mortality rate of 791/1000 babies. Conclusion: Uterine rupture is a major cause of maternal and perinatal death in Lagos, Nigeria.

Keywords

• Maternal mortality
• perinatal mortality
• uterine rupture