Uterine Rupture: Maternal and Perinatal Outcome

Abstract

Objective •

To evaluate maternal and perinatal outcome in patients with uterine rupture.

Study design

Cross-sectional study.

Place & Duration of study

Department of Obstetrics and Gynecology, Jinnah Postgraduate Medical Center (JPMC) Karachi, from January 2018 to December 2018.

Methodology

All cases of ruptured uterus that occurred during pregnancy in patients admitted either through emergency or developed this complication at hospital, were enrolled in the study after informed consent. History and physical examination findings were noted and maternal and perinatal outcome was analyzed. Patients were followed up to one month after surgery for the development of complications. Data compilation and analysis were done by using SPSS version 25.

Results •

A total of 63 patients were managed. Mean age of study subjects was 30.78±4.75 year. Forty-eight (76.1%) women were between 26 – 35 years of age and 49 (77.7%) were mothers of 2 -4 children. Forty-three (68.3%) had gestational age more than 35 weeks. Majority (n=56 - 88.9%) were un-booked cases. Forty-eight (76.2%) patients had rupture in previously scarred uterus; however 15 (23.8%) patients had uterine rupture in previously un scared uterus. Eleven (17.5%) patients underwent obstetrical hysterectomy, four (6.3%) had uterine and bladder repair, while 48 (76%) had only uterine repair. Bladder injury found in 3 (4.8%) and disseminated intravascular coagulation observed in 7 (11.1%) patients. Fifty-four (85.7%) patients had fresh still birth and 7 (11.1%) babies were delivered alive.

Conclusion

High maternal morbidity and perinatal mortality is attributed to uterine rupture as noted in this study.

Key words

Uterine rupture, Maternal morbidity, Perinatal mortality, Obstetrical hysterectomy, Uterine repair.