Study of cases of rupture uterus in a tertiary institute and its maternal and perinatal outcome

Abstract

Background: Uterine rupture is undoubtedly one of the most tragic events that can occur in a women’s life and tragedy becomes more grim when she is young. In India, in advanced cities the incidence of rupture preceded by obstructed labour is decreasing, in rural parts where there is inadequate care, lack of communication and transport, home deliveries by untrained dais incidence of rupture uterus is still high. So, the study is to evaluate the etiological factors, incidence, management modalities and maternal and perinatal outcome.Methods: A prospective cross-sectional study of 46 cases of rupture uterus and maternal and Perinatal outcome, in the department of Obstetrics and Gynecology in government tertiary reference center.Results: Overall incidence of uterine rupture is 1 in 924. Out of 46 cases 07 (15.22%) were booked, and 39 (84.78%) were referred patients. The 20-30 years age group is the most vulnerable age group. Out of 44 rupture uterus during labor, 13 (22.72%) were spontaneous of intact uterus and 31(70.45%) were in scarred uterus. Subtotal abdominal hysterectomy was commonest modality of treatment used (28 out of 46 cases), followed by suturing of tear. There were 5 maternal deaths out of 46 patients, giving maternal mortality rate of 13.51%. Perinatal mortality rate still on higher side was 76.08%.Conclusions: Most cases of rupture uterus are preventable with good antenatal and intra-partum care. Our study shows that there has been a decline in the overall morbidity in cases of rupture uterus and so also the mortality rate (decreased from 24.3 to 13.51%).

Ruptured uterus outcome among the pregnant women admitted in a tertiary care centre

“…From the time of diagnosis to delivery, only 10-37 minutes are available before clinically significant fetal morbidity becomes inevitable. 10 Identifying the high-risk pregnancies for rupture uterus and their timely referral from grass root level is an important step in secondary prevention.…”