Pregnancy after rupture of the pregnant uterus

Abstract

Pregnant women managed by us after suture repairs for rupture of the pregnant uterus between 2006 and 2009 in Enugu, South-east Nigeria were reviewed. Five pregnancies were managed during the study period. Four had normal pregnancies. Three booked early in pregnancy and had repeat caesarean deliveries at 36 weeks' gestation. One booked at another private hospital but had emergency caesarean section at 38 weeks' gestation. The fourth woman had repeat rupture at 28 weeks' gestation, suture repair and bilateral tubal ligation. Four healthy babies were discharged home. There was no maternal death. The outcomes of pregnancies after rupture of the pregnant uterus are good. Suture repairs should be the method of choice whenever preservation of future fertility is necessary. The woman and her family must be counselled on the associated risks and the need for hospital delivery by elective caesarean section in the subsequent pregnancies before discharge.

Outcome of subsequent pregnancies post uterine rupture in previous delivery: A case series, a review, and recommendations for appropriate management

“…Overall, the risk of perinatal death was of 3.4% (26/776) with rates ranging between 0.9% (one case over 109 pregnancies, Thisted et al 19 ), and 20% (one case out of five reported, Okafor et al 22 ). Perinatal death was almost exclusively due to a repeat uterine rupture with the fetus stillborn.…”

Fertility after complete uterine rupture

“…Thirteen articles were found [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] (references [31] and [32] reported the same cases). Full-text articles reporting about subsequent fertility and pregnancy after complete uterine rupture were retrieved.…”

“…The search for this period yielded seven case reports of 1-22 patients [30][31][32][33][34][35][36][37]. Table 2 summarizes these seven reports.…”

Uterine scar defects

“…The article by Okafor et al (2011) describes successful management of five pregnancies after the uterus had ruptured in an earlier pregnancy and had been repaired using chromic catgut No. 2 gauge in two layers.…”