Uterine Rupture at LUMHS: A Review of 85 Cases

Objective: to evaluate risk factors, management and pregnancy outcome of patients with uterine rupture at teaching hospital design: prospective observational study. setting: obstetrical and gynecology unit ii, liaquat university hospital hyderabad-pakistan; from 1st january 2004 to 31st december 2007. patients and methods: all patients diagnosed as case of intrapartum uterine rupture were approached. a predesigned proforma was used to collect the demographic features, predis- posing risk factors, management and feto-maternal outcome. data fed to spss program version 10 to analyse the results. results: total maternity admissions were 12678 with 11961 deliveries. a total number of 85 cases of uterine rupture were identified, giving a ratio of 0.7% or 1:141 deliveries. there were 46 cases in scarred and 39 cases with unscarred uteri. highest incidence was found in age group 25-30 years (57.6%) and in parity group 1-3 (62.3%). misuse of oxytocics (85.8%), scarred uterus (54.1%), obstructed labour (42.3%) and grand multiparty (21%) were found as main predisposing factors. uterine repair was done in 61% of cases while hysterectomy was performed in 39% cases. bladder repair was additionally required in 9.5% of cases. there were 6 (7%) maternal and 64 (75%) perinatal deaths due to uterine rupture. conclusion: uterine rupture is yet a common obstetrical emergency in our area. the significant morbidity and mortality deserves our special attention by a collaborative approach. regular antenatal checks, careful selection of patients for vaginal delivery, vigilantly monitored labour with smooth switch-over to operative delivery can reduce this drastic obstetrical complication.