Uterine rupture is still a common problem in developing countries although even here the incidence varies from urban to rural settings. This article is a review of uterine rupture in an urban referral hospital in Malaysia. It examines aetiology, clinical presentation, complications and management of the problem. Meticulous screening of patients together with optimal antenatal and intrapartum care will markedly reduce the incidence of uterine rupture. Early diagnosis and prompt treatment will further help reduce morbidity and mortality to both mother and fetus.

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The standard sperm parameters, and a newly developed assay, the hypoosmotic swelling (HOS) test, of 208 ejaculates were correlated with in vitro fertilization (IVF) outcome to assess their predictive value of the fertilizing capacity of spermatozoa. One hundred fifty-three (73.6%) of the ejaculates possessed spermatozoa that fertilized at least one oocyte and were considered fertile. Among the semen parameters studied, only the HOS test had a relatively high (r = 0.46, p less than 0.001) association with the fertilizing capacity of the spermatozoa. This test was also able to predict the outcome of IVF more reliably than the other semen parameters studied.

Over a 17-year period, 15 patients with acute puerperal inversion of the uterus were managed at the University Hospital, Kuala Lumpur, an incidence of 1 in 4,836 deliveries. Injudicious traction on the umbilical cord before the uterus was well contracted, was probably the most important causative factor. Haemorrhage was more severe when removal of the placenta was done prior to correction of the inversion. Either the hydrostatic method or manual replacement were used but more often a combination of both techniques was found necessary. With careful management of the third stage of labour, this complication can be avoided.