title: Management of uterine rupture: a case report and review of the literature.
abstract: BACKGROUND
  Maternal morbidity and mortality has been a major World Health Organization concern over the years, especially in sub-Saharan Africa. This paper reports uterine rupture with severe hypovolemic shock managed at the Douala General Hospital, Cameroon. Early clinical diagnosis is paramount to maternal survival.
  
  
  METHODS
  Mrs. MM aged 25 years, G3P2012, of the Bamileke tribe in Cameroon was admitted to our Department in hypovolemic shock BP = 70/40 mmHg, pulse 120 beats per minute, with altered consciousness (Glasgow Coma Scale = 13). She has a history of missed abortion at 19 weeks gestation and an attempt to evacuate the uterus with misoprostol that led to uterine rupture. She underwent a total abdominal hysterectomy and blood transfusion. Her post-operative stay in hospital was uneventful.
  
  
  CONCLUSIONS
  Uterine rupture is a complication that can be eliminated under conditions of best obstetric practice. To attain this objective, use of misoprostol in primary health facilities should be stopped or proper management of the medication instituted. The survival of patients after uterine rupture depends on the time interval between rupture and intervention, and the availability of blood products for transfusion.
authors.affiliation: Department of Obstetrics and Gynecology, Douala General Hospital, Douala, Cameroon. toegbe@gmail.com.|Faculty of Health Sciences, University of Buea, Buea, Cameroon. toegbe@gmail.com.
authors.forename: Thomas Obinchemti
authors.identifier: http://orcid.org/0000-0002-4485-9517
authors.initials: TO
authors.lastname: Egbe
authors.affiliation: Department of Obstetrics and Gynecology, Douala General Hospital, Douala, Cameroon.|Faculty of Health Sciences, University of Buea, Buea, Cameroon.
authors.forename: Gregory Edie
authors.initials: GE
authors.lastname: Halle-Ekane
authors.affiliation: Department of Obstetrics and Gynecology, Douala General Hospital, Douala, Cameroon.|Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.
authors.forename: Charlotte Nguefack
authors.initials: CN
authors.lastname: Tchente
authors.affiliation: Operating Theatre, Douala General Hospital, Douala, Cameroon.
authors.forename: Jacques Ernest
authors.initials: JE
authors.lastname: Nyemb
authors.affiliation: Department of Obstetrics and Gynecology, Douala General Hospital, Douala, Cameroon.|Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaoundé, Cameroon.
authors.forename: Eugene
authors.initials: E
authors.lastname: Belley-Priso
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000009:adverse effects; D000328:Adult; D001803:Blood Transfusion; D002163:Cameroon; D019468:Disease Management; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007044:Hysterectomy; D016595:Misoprostol / Q000009:adverse effects; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012769:Shock / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014597:Uterine Rupture / Q000139:chemically induced / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol
keywords: Blood products; Emergency; Hysterectomy; Laparotomy; Transfusion; Uterine rupture