Background: Uterine rupture in pregnancy is a deadly obstetrical emergency endangering the life of both mother and fetus. Methods: The present prospective study was conducted to analyse the various types of rupture uterus, changing trends of uterine rupture and surgical management along with maternal morbidity, mortality and perinatal outcome in these cases. Results: In this study, total cases were 42,205 of deliveries and 179 cases of rupture uterus giving incidence as 0.42 % that is 1 per deliveries. Complete uterine rupture are mush common i.e. (77.71 %) than incomplete rupture. Postnatal rupture was found in 11 cases. Uterine / scar repair was done in 53.11 % while obstetric hysterectomy was done in 46.89 % of cases. Most common additional surgical procedure was repair of rupture bladder i.e. 13 cases. Cervical / vaginal / perennial tear repair was performed in cases of rupture uterus from obstructed labour. A total 13 mortality occurred in cases of rupture uterus. Most common cause of maternal mortality is haemorrhagic shock, accounting for 61.23% of total maternal mortality. Majority of babies i.e. 71.9 % were still born and only 21.2 % were born alive and healthy. Neonatal death occurred in 6.7 % of cases. Fetal mortality in cases of uterine rupture is very high. Conclusion: It is concluded that due to changing obstetric practices and with liberalization of practices of caesarean section, the incidence of scar rupture is on a rise and will further increase in near future therefore pregnant woman with previous scar should be given trial after proper risk assessment and only in set up where 24 hrs emergency services for caesarean section.

Background:The aim of this study is to evaluate Maternal & Perinatal outcome in cases of Severe Acute Maternal Morbidity. Result: All the 124 patients of severe acute maternal morbidity required either HDU/ICU admission for intensive/ invasive monitoring. Out of 124 patients, 65(52.4%) patients required operative interventions. 69 (55.64%) patients required the use ionotropes as immediate life saving measure as most of the patients came in hemorrhagic shock. Transfusion of blood and blood products was require in 99 (79.8%) patients. Hemorrhage was the leading cause of severe acute maternal morbidity in our setting accounting for 62.9% of the cases, followed by hypertensive disorders of pregnancy representing 20.16% of total cases. In the present study 83.5% babies delivered at term and 16.49% were preterm. Preterm induction of labour had to be done in favour of maternal health. In the present study 41.75% of the babies were live and were discharged healthy. 53.8% babies were stillborn and 4.39% were neonatal deaths. Higher incidence of stillborn babies is attributed to the severe morbidity of the mother. Conclusion:The most common reason of SAMM was Hemorrhage due to ruptured ectopic pregnancy, followed by Hypertensive disorders of pregnancy like eclampsia. Active management of third stage of labor, easy availability of blood & blood products & timely surgical interventions has helped save lives of the patients suffering from Acute Blood loss & Hemorrhagic shock. SAMM review can be useful surrogate of maternal death analysis in this centre. SAMM is mostly associated with adverse perinatal Outcome. All these factors could be minimized by initiating a broad debate on healthcare policies, mass education on good antenatal care, introducing preventive measures and improving the training of the health professionals and services providing obstetric care.

No abstract

No abstract

No abstract