title: Uterine rupture in resource-poor countries.
abstract: OBJECTIVE
  Rupture of the gravid uterus is an obstetric catastrophe associated with high levels of maternal-fetal mortality and morbidity.
  
  
  OBJECTIVE
  The aim of this study was to review the clinical experience with uterine rupture in resource-poor countries.
  
  
  METHODS
  A MEDLINE search of the clinical literature since 1960 was carried out using the headings "uterine rupture" and "ruptured uterus," including the Medical Subject Heading "developing countries." Further bibliographic compilation was assisted by hand searches of references from retrieved articles. The available articles were then reviewed, synthesized, and summarized.
  
  
  RESULTS
  Uterine rupture remains a major obstetric problem in resource-poor countries. In industrialized, high-resource countries, uterine rupture occurs most often in women who have had a previous cesarean delivery, whereas in resource-poor nations, uterine rupture is more commonly associated with obstructed labor, injudicious obstetric interventions/manipulations (often performed by untrained birth attendants), lack of antenatal care, grand multiparity, and poor access to emergency obstetric care. Uterine rupture after a prior cesarean delivery is becoming more common in these countries as more women gain access to emergency obstetric care.
  
  
  CONCLUSIONS
  Uterine rupture afflicts the world's poor women disproportionately. In resource-poor settings, uterine rupture is a reflection of ill-equipped, badly managed, and underresourced health care systems that seem largely indifferent to the reproductive health needs of women. The ultimate success (or failure) of these countries depends in large part upon their commitment to maintaining a healthy and productive female population.
authors.affiliation: Director of Residency Training and Assistant Professor.
authors.forename: Yibrah
authors.initials: Y
authors.lastname: Berhe
authors.affiliation: Fulbright Scholar and Visiting Professor, Department of Obstetrics & Gynecology, Ayder Referral Hospital, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; and Professor of Obstetrics and Gynecology, Department of Obstetrics & Gynecology, School of Medicine, and Professor of Anthropology, Department of Anthropology, College of Arts and Sciences, Washington University, St Louis, MO.
authors.forename: L Lewis
authors.initials: LL
authors.lastname: Wall
mesh_terms: D003906:Developing Countries; D005260:Female; D006801:Humans; D015995:Prevalence; D014597:Uterine Rupture / Q000453:epidemiology / Q000209:etiology