Frequency, Risk Factors, Management Options and Fetomaternal Outcome of Uterine Rupture in Pregnancy
Objective: To analyze the frequency, risk factors, management options and fetomaternal outcome of uterine rupture in pregnancy.
Methodology: This observational cohort study was conducted at the department of obstetrics & gynaecology, Unit II Ghulam Muhammad Mahar Medical College Hospital Sukkur, from January 2018 to December 2020. All pregnant women above 24 weeks gestational age admitted with or developed uterine rupture at the hospital were included. Women with less than 24 weeks gestational age or who developed uterine rupture after vaginal birth after C-section (VBAC) in a hospital or admitted with this complication were excluded from this study. Data was collected on specially designed Performa after taking informed consent. The student's T-tests have been applied. SPSS Version 16 was used to analyze data.
Results: Total number of uterine rupture cases was 32(0.6%) out of 5204 deliveries for three years. The most typical age group of patients was 26-35, about 43%, grand multiparous in (60.2%) cases. Previous Caesarean Section in 18 (56.2%) was the most commonest risk factor. Repair of the ruptured uterus was the primary management option in 22 (68.75%), followed by Caesarean Hysterectomy in 10(31.2%) cases. Maternal mortality was in 1(3.1%) patient. Perinatal mortality was 26(81.2%), and 6(18.75%) were alive babies.
Conclusion: This study concludes that previous cesarean section is the leading cause of rupture uterus, followed by injudicious use of oxytocin. Proper Antenatal care and training programs for healthcare providers and traditional birth attendants (TBA) are needed to prevent this severe but avoidable complication.
Keywords: Rupture uterus, previous caesarean section, Hysterectomy, oxytocin, vaginal birth after C-section (VBAC).
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