ABSTRACT
Background: Uterine rupture has continued to be an obstetric catastrophe with tragic maternal and foetal outcomes particularly in Nigeria.Methods: an institutional, cross sectional retrospective study was carried out at Jos University Teaching Hospital, North-Central Nigeria. Case files of mothers with uterine rupture managed at the hospital from 1 January 2011 to 31 December 2019 were retrieved and included in the study. Data extracted from case files included maternal age, parity, gestational age, booking status, presence of uterine scar, obstetric interventions prior to rupture, site of rupture, type of surgery, units of blood transfused, intensive care unit admission and duration of hospital stay and maternal or foetal death.Results: the incidence of uterine rupture was 1 in 497 deliveries (0.2%). The mean age of the patients was 30.1±5.1years. About 75% of the patients were para 1-4. Seventeen (70.8%) patients were unbooked while fourteen (58.3%) had unscarred uterine rupture. Eight out of 14(57.1%) patients with unscarred uterus had uterotonics for induction or augmentation of labour. Fourteen (58.3%) patients had rupture involving anterior lower uterine segment. Over half of the patients had uterine repair only (58.3%), 29.2% had uterine repair with bilateral tubal ligation while 12.5% had subtotal hysterectomy. Twenty-two (91.7%) required blood transfusion, five patients had 5 or more units of blood transfused. The perinatal mortality was 69.6%, there was no maternal death.Conclusions: the major predisposing factors to uterine rupture in our facility were lack of antenatal care, presence of previous caesarean section scar and injudicious use of uterotonics.
ABSTRACT
Background: Induction of labour (IOL) is a common procedure that remains a relevant Obstetric procedure. The maternal and perinatal outcomes are paramount hence the need to review the intervention in order to implement needed change. Objectives: To determine incidence, indications, outcome and complications of induction of labour at the Jos University Teaching Hospital (JUTH), Jos, Nigeria. Methods: This was a retrospective study reviewing 584 women who had IOL in JUTH from January 2004 to December 2007. Parameters selected for review include parity, gestation age, outcome and cervical state prior to IOL. Results: Four hundred and eighty women had vaginal deliveries (82.2%). There were fifty two induced on account of antepartum Intra Uterine Foetal Deaths (IUFD), while 1.5% of the deliveries ended up as still births, 10.5% had birth asphyxia and neonatology review and care. Thirty two patients had various complications after IOL. There were no maternal mortalities. Conclusion: Parity and presence of IUFD were found to influence the outcome of IOL.