Frequency, predisposing factors and fetomaternal outcome in uterine rupture.
OBJECTIVE
To determine the frequency and to analyze the predisposing factors, maternal and fetal outcome of uterine rupture.


METHODS
Cross-sectional study.


METHODS
The Department of Gynaecology and Obstetrics, Jinnah Postgraduate Medical Centre, Karachi from February 1997 to January 2000.


METHODS
All cases of ruptured uterus, who were either admitted with or who developed this complication in the hospital, were included in the study. Demographic data, details regarding the most probable predisposing factor, type of rupture, the management and maternal and fetal outcome were taken into consideration for analysis.


RESULTS
During three years, total number of deliveries was 18668, and there were 103 cases of uterine rupture (0.55%). Out of these, only 13 (12.62%) patients were booked. Most of the patients presented between the ages of 26-30 years (42.71%). Majority of ruptures occurred in para 2-4 (44.66%). Fifty-five cases (53.39%) had a previous caesarean section scar. In 68 (66.01%) cases, the tear was located in lower uterine segment. In 93 (90.29%) cases, anterior uterine wall was involved. Rupture was complete in 79 (76.69%) cases. Repair of uterus was done in 79 (76.69%) cases. Hysterectomy was performed in 24 (23.30%) cases. There were 8 (7.76% or 77.66/1000) maternal deaths and 85 (81.73% or 825 / 1000) perinatal deaths.


CONCLUSIONS
This study confirms high frequency of such serious preventable obstetrical problem which can lead to high fetomaternal mortality. Rupture of caesarean section scar was the most common cause of uterine rupture found in this series.
Malik
Humaira Saeed
HS
Department of Obstetrics and Gynaecology, Jinnah Medical College Hospital, SR-6, Sector 7-A , Korangi Industrial Area, Karachi. humdr@yahoo.com
D000293:Adolescent; D000328:Adult; D002585:Cesarean Section; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D008423:Maternal Age; D008428:Maternal Mortality; D010298:Parity; D011247:Pregnancy; D012307:Risk Factors; D014597:Uterine Rupture / Q000209:etiology* / Q000503:physiopathology*