Maternal and perinatal outcome in rupture of unscarred uterus: a case series

Abstract

Uterine rupture is one of the main contributory factors of maternal morbidity and fetal mortality. The aim of this study was to study the maternal and perinatal outcome in rupture of unscarred uterus and to identify the etiology, risk factors, diagnosis and management in a tertiary care centre. This case series study was often cases of rupture of unscarred uterus conducted at the department of obstetrics and gynecology, Nazareth hospital, Shillong, Meghalaya from July 2018 to February 2021. During the study period there were 7840 deliveries and ten patients presented with rupture of unscarred uterus, the incidence being 0.127 %. The patients were referred from different primary health centres and all patients presented with history of trial of home delivery. All patients were multigravida and the highest parity was a patient with para 11. The cases were between the gestational age of 39 to 41 weeks. Rupture was observed in the lower uterine segment in 5 patients, left lateral wall in 3 and right lateral wall in 2 patients. Five patients underwent hysterectomy, and 4 patients had repair of the rupture. There was one maternal death. Grand multipara and trial of home delivery were the most common identifiable risk factors along with obstructed labour. Identifying high risk women, prompt diagnosis, early referral from periphery and active management is the key factor to avoid adverse maternal and perinatal outcome.