Ruptured uterus in Kaduna, Nigeria: a six-year review

Abstract

A six year review in a Nigerian University Teaching Hospital revealed that the incidence of ruptured uterus is 1 per 137 deliveries. The mean age of patients was 30.5 years. Ruptured uterus occurred in younger women with a scarred uterus compared with the unscarred group. The incidence of ruptured uterus was highest in women who were para 5 and above. Cephalopelvic disproportion was the most important obstetric factor associated with rupture (63.4%). Abdominal tenderness (46.3%), vaginal bleeding (31.7%) and pallor (31.7%) were the commonest clinical features at presentation. Shock (22%) was commonest in the unscarred group. Repair with tubal sterilisation was the commonest method of treatment. Diarrhoea was the commonest postoperative complication (39%). Maternal and perinatal mortality rates were 22% and 88% respectively. Improving the emergency capability of the hospital and more efforts at educating our women and reducing poverty will go a long way towards reducing the incidence and adverse clinical outcome of ruptured uterus.

Risk factors and perinatal outcome of uterine rupture in a low-resource setting

“…It is not surprising that the majority (>60%) of the patients with uterine rupture was unbooked and had not availed themselves of available obstetric services in the index pregnancy. This figure compares favourably with reports in various parts of Nigeria and Africa,5681117 supporting the notion that lack of antenatal care was associated with increased maternal and foetal morbidity in uterine rupture 341011…”

“…Most reports have identified not registering for antenatal care as a risk factor for uterine rupture 341011. Maternal case fatality rates as high as 10.3% and 16.0% have been reported, while the foetal mortality rates are even much higher at 70%12 and 90% 13141516.…”