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Introduction: Rupture uterus is an uncommon and frequentlycalamitous circumstance. It is connected with a highoccurrence of fetal and maternal mortality and morbidity.Objective: Our primary objective of this investigation is toassess results of uterine rupture among women with earliercesarean section.Method: This cross-sectional study was done at JalalabadRagib Rabeya Medical College Hospital, Sylhet from January2016 February to 2019 February. All out 63 instances ofruptured uterus were recorded in this investigation and everyone of the instances of ruptured uterus who were eitherconceded with complain or who developed it in medical clinicwere incorporated into the examination.Results: During the examination most events of ruptureduterus was the gestational age 37-40 weeks, (66.67%) andamong 63 patients, most (65.08%) had no antenatal checkup.(34.92%) had unpredictable antenatal checkup. Likewise therupture was bound to lower segment in the abdominal uterus.Conclusion: Lack of antenatal care, misuse of oxytocin, andinappropriate counseling of patients with history of previouscaesarian section for hospital delivery are the main causes fora ruptured uterus in this study.
ABSTRACT
Background– Obstructed labour is a life threatening obstetric complication associated with significant maternal and fetal morbidity and mortality .Maternal mortality is largely due to PPH, puerperal infection or rupture uterus and perinatal mortality is mainly due to asphyxia. Methods– Prospective study of two years duration with sample comprised of 250 cases of obstructed labour randomly selected from all patients admitted to labour room with obstructed labour were included in this study. Results – The incidence of obstructed labour was 3.67% .72% were referral cases. Majority were primigravida(60.8% ) and between21–30 years(72.4%) .Common causes were Cephalopelvic disproportion( 54.4%) , malpresentation and malposition( 42%) and fetal malformation (1.6%).Delivery was by Caesarean section (80.4 %), forceps application ( 6.8 %)and destructive operations (1.6% ).Out of 28 cases of ruptured uterus,17 (6.8%) and11(4.4%) were managed by subtotal hysterectomy and uterine repair respectively.Maternal morbidity was 86.4% , causes being Puerperal pyrexia (37.6%) , post partum haemorrhage (20.8%) and wound infection (14.4%). Maternal deaths (1.6%) due to endotoxic shock and primary PPH.Perinatal mortality was21.14%. Commonest causes of neonatal morbidity were birth asphyxia (38.33%) of live births, jaundice (29.96%) ,septicaemia (18.94%) and Meconium aspiration syndrome (13.66%). Most of neonatal deaths were due to severe birth asphyxia (54.17%) followed by septicaemia (20.83%) Conclusion – Obstructed labour is a frequently encountered obstetric complication associated with very high maternal and perinatal morbidity and mortality. It can be prevented by providing good nutrition and optimal obstetric care .Effective antenatal care and early detection of risk factors and timely referral will prevent the complication due to obstructed labour.
ABSTRACT
Rupture uterus is a rare and often catastrophic condition. It is associated with a high incidence of fetal and maternal mortality and morbidity. Our objective in this study is to determine incidence, etiology, trend, management, maternal and fetal outcome of uterine rupture in Faridpur Medical College Hospital. This is a prospective cross-sectional study of patients with ruptured uterus from the period of January 2011 to December 2011 admitted at Faridpur Medical College Hospital. All the cases of ruptured uterus who were either admitted with uterine rupture or who developed it in hospital were included in the study. Patients having ruptured uterus due to congenital anomaly were excluded from the study. Patients were initially assessed in labour ward, relevant sociodemographic data, previous antenatal and surgical history recorded. Ways of management, maternal and fetal outcome were taken for analysis. There were 30 cases of ruptured uterus out of total 3606 deliveries (including 1809 caesarian sections) over a one year time period, with a prevalence of 0.83%. The most common age group was 21-30 years. A majority of patients 16(53.3%) were cases of unscarred uterus presenting with rupture; the common cause of rupture in scarred uterus was injudicious use of oxytocin (13,43.33%). Proper antenatal care, appropriate counseling of patients with history of previous caesarian section for hospital delivery, training of skilled birth attendant can reduce mortality and morbidity due to rupture uterus.
ABSTRACT
Uterus is the most unique reproductive organ in humans. Rupture uterus is a hazardous complication of pregnancy and labour, and carries high risk both to the mother and the foetus. Uterine rupture during third trimester of pregnancy is a rare complication but if there is rupture and not suspect with in time may have fatal out come for the mother, foetus or both. In this modern medical era, prenatal check-up, advanced non invasive diagnostic facilities and subsequent treatment does not produce such life threatening complication. Rupture uterus cases are observed due to either carelessness of the patient or negligence of the doctor. Three cases of rupture uterus are discussed in this paper of full term pregnancy, had complete antenatal visits with all investigations including ultrasonography and attended the hospital well in time before death. Most cases of rupture uterus are preventable with good ante-natal and intra-partum care, and proper identification of high-risk cases.