Uterine rupture during pregnancy and delivery among women attending the Al-Tthawra Hospital in Sana'a City Yemen Republic

Abstract

Background: About 20 percent of the population in developing countries is composed of women of reproductive age. These women face one of the catastrophic risks of pregnancy "uterine rupture". Studies conducted in the developing world give strong evidence that uterine rupture is a major health problem in these countries with the rate being high in rural areas.Aim: The purpose of the study was to estimate the incidence and determine the risk factors and outcome of uterine rupture among women using the referral hospital Al-thawra in Sana'a City, Yemen republic and to extrapolate the data to the whole of Yemen.Methods: The data was collected retrospectively; by interviewing, examining and following up all the cases of uterine rupture coming to the hospital during a period of 9 months between September 1996 and May 1997. A descriptive analysis and distribution frequency of the commonest causes of uterine rupture in 37 cases are presented taking into account medical, reproductive, health services provided and sociodemographic factors.Results: Incidence of uterine rupture in Yemen was found to be (0.63), obstructed labor 83 %, contracted pelvis 19 %, previous surgery in 48 %, Oxytocine infusion in 42 %. Grand-multiparty was in 65 % and maternal age over 35 years in 50 %. Antenatal care was only in 34 %. Conclusion:The high percentage of malpresentation, cephalopelvic disproportion, previous uterine surgery accompanied by the high percentage of use of Oxytocin in this study highlights very clearly the role of this medication in increasing the risk of uterine rupture in Yemen.

Rupture uterus: a prospective observational study of 25 consecutive cases in a tertiary referral centre in South India

“…In other studies, like in the Nigerian study and the Yemen study, the proportion of obstructed labours leading to ruptures was very high. 19,20 Ruptures of the uterus related to injudicious use of oxytocics, Oxytocin or Prostaglandins, was noted in 12% of our subjects. The same was comparable to 18% quoted by Sunitha K et al, and 5.52% in the study done by Sahu L et al 6,8 In the study from Yemen these figures, pertaining to use of Oxytocin infusion are very high-41.7%.…”

“…The same was comparable to 18% quoted by Sunitha K et al, and 5.52% in the study done by Sahu L et al 6,8 In the study from Yemen these figures, pertaining to use of Oxytocin infusion are very high-41.7%. 20 Diagnosis was on the basis of clinical presentation in all except two of our cases; symptoms of pain abdomen, vaginal bleeding, prolonged labour; signs like poorly defined uterine contour, superficially felt foetal parts, absent foetal heart sounds, severe anaemia, sudden collapse or those presenting with shock, were most often corroborated by paracentesis to demonstrate haemoperitoneum. Cardiotocograph picked up the foetal bradycardia, in one case of TOLAC.…”

“…In our study, the incidence of rupture uterus was 0.11%, which was much less compared to the incidence reported from other developing countries; 0.8% in Ghana, 0.76% in Uganda, 0.74% in Pakistan, 0.9% in Nepal, 2.8% in Ethiopia and 0.63% in Yemen. [15][16][17][18][19][20] Studies from developed countries showed incidences as low as 0.035%. 21 The incidence in other Indian studies is comparable to our study varying from 0.061% to 0.28%.…”

A 3 Year Study of Rupture Uterus at a Tertiary Hospital

“…them, the result is a chance of rupture uterus and as well as rupture of previous caesarian scar 4 . High maternal mortality and morbidity is a consequence of poor maternal care, inadequate socioeconomic and environmental condition, poor accessibility to health services and poor nutrition 5 . The objective of the study is to determine the incidence, etiology, trend, management and maternal and fetal outcome of ruptured uterus and to identify the preventive measures.…”

A study of cases of rupture uterus in a tertiary medical college of Jharkhand, India

“…3 High maternal mortality and morbidity is a consequence of poor maternal care, inadequate socioeconomic and environmental condition, poor accessibility to health services and poor nutrition. 5 Injudicious use of oxytocin, use of prostaglandin for induction of abortion or labor, forcible external version under general anesthesia and fall or blow on the abdomen are known to increase the risk of uterine rupture during pregnancy. 4 Several studies suggest that for adequately screened women with prior caesarean section, a trial of labour is safer than elective repeat caesarean section in hospital environment.…”