Uterine rupture in pregnancy: a five-year study.

BACKGROUND: Uterine rupture during pregnancy is a rare occurrence that frequently results in high incidence of maternal and fetal morbidity and mortality.

AIM: To study the incidence, risk factors, maternal and fetal outcome of uterine rupture.

STUDY DESIGN: A retrospective study.

METHODS: A retrospective study was carried out in the Department of Obstetrics and Gynecology in a tertiary health care center. The cases of uterine rupture whether booked or unbooked that were received and managed in the hospital over a period of 5 years from January 2002 to December 2006, were included in the study.

RESULTS: The total number of uterine rupture cases was 57 out of 33,394 deliveries. The incidence of uterine rupture was 0.17%. Majority of the patients belonged to age group 30-34 years and were multiparas. Most of the cases were due to obstructed and neglected labor (52.63%), 35.08% due to scar rupture and 8.77% were due to uterine trauma. The bladder injuries were found in 8.77%. Repair of the uterine rent was possible in 70.18% (40/57) cases. Hysterectomy was done in 29.82% cases. Stillbirths were observed in 94.74% of women with uterine rupture. There was no maternal mortality.

CONCLUSIONS: The leading cause of uterine rupture was found to be neglected and obstructed labor due to mismanagement by local untrained birth attendants. Timely recognition and referral to higher centers can reduce the maternal and fetal morbidity and mortality due to uterine rupture.