OBJECTIVE: To evaluate risk factors, management and pregnancy outcome of patients with
uterine rupture at teaching hospital
DESIGN: Prospective observational study.
SETTING: Obstetrical and Gynecology Unit II, Liaquat University Hospital Hyderabad-Pakistan;
from 1st January 2004 to 31st December 2007.
PATIENTS AND METHODS: All patients diagnosed as case of intrapartum uterine rupture were
approached. A pre-designed proforma was used to collect the demographic features, predisposing
risk factors, management and feto-maternal outcome. Data fed to SPSS program version
10 to analyse the results.
RESULTS: Total maternity admissions were 12678 with 11961 deliveries. A total number of 85
cases of uterine rupture were identified, giving a ratio of 0.7% or 1:141 deliveries. There were 46
cases in scarred and 39 cases with unscarred uteri. Highest incidence was found in age group
25-30 years (57.6%) and in parity group 1-3 (62.3%). Misuse of oxytocics (85.8%), scarred uterus
(54.1%), obstructed labour (42.3%) and grand multiparty (21%) were found as main predisposing
factors. Uterine repair was done in 61% of cases while hysterectomy was performed in 39%
cases. Bladder repair was additionally required in 9.5% of cases. There were 6 (7%) maternal
and 64 (75%) perinatal deaths due to uterine rupture.
CONCLUSION: Uterine rupture is yet a common obstetrical emergency in our area. The significant
morbidity and mortality deserves our special attention by a collaborative approach. Regular
antenatal checks, careful selection of patients for vaginal delivery, vigilantly monitored labour
with smooth switch-over to operative delivery can reduce this drastic obstetrical complication.
Uterine rupture, scarred uterus, grand multiparty, hysterectomy, uterine repair.