A TWO-YEAR ANALYSIS OF UTERINE RUPTURE IN PREGNANCY

Authors

  • Ansa Islam Gynaecology Unit, Ayub Medical College & Ayub Teaching Hospital, Abbottabad.
  • Azmat Ali Shah ATH
  • Humaira Jadoon ATH
  • Aneesa Fawad ATH
  • Maria Javed ATH
  • Aziz-un Nisa Abbasi ATH

Abstract

Background: Uterine rupture, an obstetrical emergency though rare but still has grave implications. Uterine rupture is the occurrence of breach in the wall of uterus. Complete rupture involves complete disruption of uterine wall resulting in spillage of uterine contents into the abdominal cavity whereas an incomplete rupture has intact peritoneum or serosa. The most commonly reported risk factor in developed countries is previous caesarean section whereas in developing countries neglected and obstructed labour are more frequently reported predisposing factors. Methods: This was a cross sectional descriptive study which was carried out for a period of 2 years from January 2015 to December 2016 in Gynae “A” unit of Ayub Teaching Hospital Abbottabad. Results:  In our study frequency of uterine rupture was 0.63%. Previous scar dehiscence was the most common risk factor for uterine rupture. Maternal mortality was 4% out of total 52 ruptured uterus, while 94.2% was perinatal mortality. Conclusion: Although uterine rupture can be prevented but its frequency is still high. Therefore, proper antenatal care, health education, utilisation of health facilities is needed to reduce adverse outcome associated with this avoidable condition.Keywords: Uterine Rupture; Scarred uterus; Fetomaternal outcome; perinatal mortality; risk factors

Author Biographies

Ansa Islam, Gynaecology Unit, Ayub Medical College & Ayub Teaching Hospital, Abbottabad.

Assistant ProfessorAyub Teaching Hospital, Abbottabad

Azmat Ali Shah, ATH

Anesthesia

Humaira Jadoon, ATH

Gynae

Aneesa Fawad, ATH

Gynae

Maria Javed, ATH

Gynae

Aziz-un Nisa Abbasi, ATH

Gynae

References

Kulkarni S, Patil S, Budihal D, Seetaram S. Rupture uterus: A 10 years review. J Obstet Gynae 1997;47:344–52.

Hofmeyr GJ, Say L, Gulmezoglu AM. WHO systematic review of maternal mortality and morbidity:the prevalence of uterine rupture. BJOG 2005;112(9):1221–8.

Cunningham FG, Gant NF, Leveno KJ, Larry C. Rupture of the uterus. In: Williams obstetrics. 21st ed. New York, NY: McGraw-Hill, 2001; p.646–52.

Sunanda N, Ranganth P. A two-year analysis of uterine rupture in pregnancy. Int J Reprod Contracept Obstet Gynecol 2016;5(11):3983–6.

Sieck CC. Vaginal birth after cesarean section: a comparison of rural and metropolitan rates in Oklahoma. Jokla State Med Assoc1997;90(8):444–9.

Cox ML. Contracted pelvis in Nigeria. J Obstet Gynaecol Br Emp 1963;70:487–94.

Fisk NM, Shweni PM. Labor outcome of juvenile primiparae in a population with a high incidence of contracted pelvis. Int J Gynaecol Obstet 1989;28(1):5–7.

Neilson JP, Lavender T, Quenby S, Wray S. Obstructed labour. Br Med Bull 2003;67:191–204.

Topuz S. Spontaneous uterine rupture at an unusual site due to placenta percreta in a 21 week twin pregnancy with previous cesarean section. Clin Exp Obstet Gynecol 2004;31(3):239–41.

Gardeil F, Daly S, Turner MJ. Uterine rupture in pregnancy reviewed. Eur J Obstet Gynecol Reprod Biol 1994;56(2):107–10.

Al-Zirqi I, Stray-Pedersen B, Forsén L, VangenS. Uterine rupture after previous caesarean section. BJOG 2010;117(7):809–20.

Iloki LH, Okongo D, Ekoundzola JR. Uterine rupture in an African environment. 59 cases at the University Hospital Center in Brazzaville. J Gynecol Obstet Biol Reprod (Paris) 1994;23(8):922–5.

Thomas A, Jophy R, Maskhar A, Thomas RK. Uterine rupture in a primigravida with misoprostol used for induction of labour. BJOG 2003;110(2):218–8.

Ezechi O, Kalu B, Njokanma FO, Nwokoro CA, Okeke G. Vaginal misoprostol induction of labour: a Nierian hospital experience. J Obstet Gynaecol 2004;24(3):239–42.

Jain R. Rupture of pregnant uterus: incidence, risk factors, maternal and fetal outcome. Int J Med Res Rev 2016;4(6):1035–41.

Ofir K, Sheiner E, Levy A, Katz M, Mazor M. Uterine rupture: risk factors and pregnancy outcome. Am J Obstet Gynecol 2003;189(4):1042–6.

Kadowa I. Ruptured uterus in rural Uganda: prevalence, predisposing factors and outcomes. Singapore Med J 2010;51(1):35–8.

Fofie CO, Baffoe P. A Two-year review of uterine rupture in a regional Hospital. Ghana Med J 2010;44(3):98–102.

Mukasa PK, Kabakyenga J, Senkungu JK, Ngonzi J, Kyalimpa M, Roosmalen VJ. Uterine rupture in a teaching hospital in Mbarara, western Uganda, unmatched case-control study. Reprod Health 2013;10:29.

Rizwan N, Abbasi RM, Uddin SF. Uterine rupture, frequency of cases and fetomaternal outcome. J Pak Med Assoc 2011;61(4):322–4.

Padhye SM. Rupture of the pregnant uterus: a 20 year review. Kathmandu Univ Med J (KUMJ) 2005;3(3):234–8.

Omole-Ohonsi A. Uterine rupture: risk factors and pregnancy outcome. Gynecol Obstetric.2011;1:1.

Lynch JC, Pardy JP. Uterine rupture and scar dehiscence. A five-year survey. Anaesth Intensive care 1996;24(6):699–704.

Khan S, Parveen Z, Begum S, Alam I. Uterine rupture: A review of 34 cases at Ayub Teaching Hospital Abbottabad. J Ayub Med Coll Abbottabad 2003;15(4):50–2.

Malik HS. Frequency, predisposing factors and fetomaternal outcome in uterine rupture. J Coll Physicians Surg Pak 2006;16(7):472–5.

Saglamtas M, Vicdan K, Yalçin H, Yilmaz Z, Yeşilyurt H, Gökmen O. Rupture of the uterus. Int J Gynaecol Obstet 1995;49(1):9–15.

Lema VM, Ojwang SB, Wanjala SH. Rupture of the gravid uterus: a review. East Afr Med J 1991;68(6):430–41.

Hasan JA, Zaki M, Kareem K. Rupture of gravid uterus. J Surg Pak Mar 2005;10:20–2.

Gul A. Rupture of previously scarred uterus. Ann King Edward Med Coll 2004;10:473–5.

Ezechi OC, Mabayoje P, Obiesie LO. Ruptured uterus in South Western Nigeria: a reappraisal. Singapore Med J 2004;45:113–6.

Ahmed SM, Daffalla SE. Incidence of uterine rupture in teaching hospital, Sudan. Saudi Med J 2001;22(9):757–61.

Fatima N. Rupture of uterus at term. J Coll Physicians Surg Pak 1998;8(3):137–9.

Ofir K, Sheiner E, Levy A, Katz M, Mazor M. Uterine rupture: differences between a scarred and an unscarred uterus. Am J Obstet Gynecol 2004;191(2):425–9.

Gessessew A, Melese MM. Rupture uterus-eight-year retrospective analysis of causes and management outcome in Adigrat Hospital, Tigray Region, Ethopia. Ethiop J Health Dev 2002;16(3):241–5.

Kafkas S, Taner CE. Ruptured uterus. lnt J Gynaecol Obstet 1991;34(1):41–4.

Latika S. A 10 year analysis of uterine rupture at a teaching institution. J Obstet Gynecol India 2006;5(6):502–6.

Ola ER, Olamijulo JA. Rupture of the uterus at the Lagos University Teaching Hospital, Lagos, Nigeria. West Afr J Med 1998;17(3):188–93.

Rashmi, Radhakrisknan G, Vaid NB, Agarwal N. Rupture uterus--changing Indian scenario. J Indian Med Assoc 2001;99(11):634–7.

Ozdemir I, Yucel N, Yucel O. Rupture of the pregnant uterus: a 9-Year review- Arch Gynecol Obstet 2005;272(3):229–31.

Published

2019-01-15