A STUDY OF RUPTURE UTERUS CASES IN TERTIARY HOSPITAL OF CENTRAL INDIA

Abstract

Background – Uterine rupture is a major cause of maternal and perinatal morbidity and mortality in developing countries. Uterine rupture can be prevented to some extent by understanding its etiology and early detection of high risk cases. Purpose- To assess the magnitude of uterine rupture, causes of uterine rupture, clinical presentation, site of uterine injury and its management. Material and Method – Total 80 women with uterine rupture were admitted during the year January 2016 to December 2020 were included in the study. Data was collected from the maternity records. Information regarding socio-demographic prole, clinical features, operative records, management, maternal and perinatal outcome was obtained. Results – Out of 49814 deliveries 80 cases were included in the study. Referred cases from rural areas were 92.5% and 68.75% women were unbooked. Mean age of women was 27 years. Multipara were 78.75% and grand multipara were 20%. Most prevalent gestation was between 35 – 40 weeks. Supercial fetal parts with vaginal bleeding or shock (53.75%) were most common presentation. Scarred uterus was the commonest cause of uterine rupture (42.5%), followed by obstructed labour (35%). Lower segment uterine rupture was most common site of uterine injury in scarred and unscarred uterus (77.5%). Uterine rent repair was done in 65%. Hysterectomy was performed in 25% cases; subtotal hysterectomy with bladder repair was in 8.75% cases. Conclusion – Women with no antenatal visit, scarred uterus and labour started at home, was having more chances of uterine rupture. Strengthening of peripheral health services will be helpful in reducing uterine rupture.