title: A review of 93 cases of ruptured uterus over a period of 2 years in a tertiary care hospital in South India.
abstract: This was a retrospective descriptive study carried out on cases in JIPMER between July 2008 and June 2010 among 32,080 deliveries. The study sample included 93 women who had a ruptured uterus. Outcome variables included maternal characteristics, risk factors, management and complications of ruptured uterus. The incidence of ruptured uterus was 0.28%. Most of these women were multiparous (95%), between 20 and 30 years (82%). The majority had a scarred uterus (77%) and 83% were at term gestation. Among women with a scarred uterus, 57 women (79%) had an unknown uterine scar type and 46 women (64%) had < 18 months' duration from the last caesarean section. A total of 37 women (39.7%) presented with ruptured uterus and a dead fetus. Out of 71 women with previous caesarean section, 46 women (49.4%) were allowed trial of scar and developed a ruptured uterus in hospital. Among women with unscarred uterus, 14 presented with rupture and seven of these women were induced in hospital. Out of the 93 cases, 87% were managed with uterine repair and 12 women underwent hysterectomy. A total of 31 babies were born with good Apgar scores; 48 babies were stillborn. We conclude that the strongest association of ruptured uterus was with previous scarred uterus, multiparity and < 18 months' duration from the last caesarean section. There were no maternal deaths. Maternal morbidity was seen in 17% of cases. Perinatal mortality was 60.6%. As a result of the study, we have implemented changes to improve patients' care.
authors.affiliation: Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. veenup_2001@yahoo.com
authors.forename: P
authors.initials: P
authors.lastname: Veena
authors.forename: S
authors.initials: S
authors.lastname: Habeebullah
authors.forename: L
authors.initials: L
authors.lastname: Chaturvedula
mesh_terms: D000328:Adult; D002585:Cesarean Section; D002921:Cicatrix / Q000150:complications; D005260:Female; D006801:Humans; D007044:Hysterectomy; D015994:Incidence; D007194:India / Q000453:epidemiology; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D010298:Parity; D011247:Pregnancy; D012189:Retrospective Studies; D050497:Stillbirth / Q000453:epidemiology; D014597:Uterine Rupture / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D014599:Uterus / Q000601:surgery