Uterine Rupture Still an Obstetric Catastrophe-A Six-Year Review in Federal Medical Centre, Asaba.

Abstract

Background: Uterine rupture is a dire obstetric emergency with far reaching maternal and perinatal morbidity and mortality. This study determined the incidence, predisposing factors and feto-maternal outcomes of ruptured uterus.

Methods: A 6-year retrospective study of all cases of uterine ruptures that were managed in Federal Medical Centre, Asaba, Delta State, Nigeria between 1st January, 2015 and 31st December, 2020 was undertaken. Data collected from maternity records were transferred to a data sheet, and analyzed using SPSS statistical software, version 20 IBM.

Results: The incidence of uterine rupture in this study was 1.2% or 1in 89 deliveries. Unbooked parturients accounted for most of the cases of uterine rupture 54(91.5%). The mean age of women analysed in this study was 31.3years (SD=4.7). Abdominal pain and vaginal bleeding 32(54.2%) were the commonest presenting complaint. Previous uterine scar 25(42.4%) was the commonest risk factor identified while rupture along a previous scar 33(55.9%) was the commonest site for uterine rupture in this study. Anaemia requiring multiple blood transfusion 46(78%) and wound infections 5(8.5%) were the commonest complications; repair alone 31(52.5%) was the surgical procedure in most of the cases. The decision intervention interval was more than thirty minutes in 94.9% of the women. Case fatality rate was 7.1%, while the perinatal mortality rate was 88.1%. There was a significant relationship between family socio-economic status and maternal outcome P = 0.020.

Conclusion: Uterine rupture is still a common obstetric emergency with increased maternal and perinatal morbidity and mortality. The commonest predisposing factor was previous uterine scar usually among unbooked parturients