Prevalence and factors associated with rupture of gravid uterus and feto-maternal outcome: a one-year retrospective cohort study

Background: Uterine rupture remains a significant public health problem contributing to 13% of maternal mortality and 74%-92% for perinatal mortality in developing countries. This study assesses the prevalence and factors associated with rupture of gravid uterus and feto-maternal outcome in Ethiopian mothers with uterine rupture.Methods: A retrospective cohort study was conducted to identify risk factors associated with rupture of gravid uterus and feto-maternal outcomes. The data source included clinical records of patients seen at Dilla University Referral Hospital over a one-year period. The data was collected using a structured data collection form developed for the purposes of the study. The study involved a total 2,498 women with a gravid uterus, gestational age of ≥28 weeks and registered in the labor and delivery registration books in the Obstetrics and Gynecology Department. Bivariate and multivariate regression analyses were carried out at 95% Confidence Interval to identify factors independently associated with uterine rupture.Results: Out of 2,498 reviewed deliveries, 46 cases developed uterine rupture making an overall hospital prevalence of 1.8 % or one in 53 deliveries. Malpresentation (80%), contracted pelvis (47.8%), vertex malposition (10.8%), and previous uterine scar (2.1%) were the causes of uterus ruptures. In multivariate analysis, clients' residence, parity, birth weight, Antenatal Care follow-up and duration of labor were statistically significantly associated with uterine rupture. Maternal and fetal case fatality rates were 8.7% and 97.8%, respectively.Conclusion: Uterine rupture remains an important problem in the study area. Patients with identified risk factor(s) should stay close to the hospital in late pregnancy. Besides, strengthening antenatal care follow-up and referral linkage should be considered

Rupture of uterus [fundus]; spontaneous rupture of an unscarred uterus [fundus], at 35 weeks 01 day of gestation of a multigravida

Rupture of a gravid uterus is a surgical emergency. Predisposing factors include a scarred uterus. Spontaneous rupture of an unscarred uterus during pregnancy is a rare occurrence. We hereby present the case of a spontaneous complete uterine rupture at a gestational age of 35 weeks 01 day in a 25 years old patient. The case was managed at the Civil Hospital Bahawalpur. She had past history of one uterine curettage for endometrial polyp one year back. She presented with mild abdominal pains of sudden onset. After conservative management for 10 hours in hospital she suddenly developed severe abdominal pains with P/V bleeding. On ultrasound scan, uterine rupture was diagnosed and an emergency laparotomy was done. The ruptured amniotic sac with baby and placenta were found in the peritoneal cavity with rupture of the uterine funds. Spontaneous uterine fundus rupture usually occurs when there is an upper segment uterine scar. This case report shows that past history of curettage is a risk factor for the presence of uterine scar

Incarceration of the Gravid Uterus with Myoma: Report of One Patient Managed with Uterine Reduction / 대한산부인과학회잡지

Incarceration of the gravid uterus is a rare but serious complication of pregnancy. Reported is the case of a gravid 2, para 0, abortus 1 with known uterine subserosal myoma(5.3 x5.5cm sized) 26-year-old woman presented with acute dysuria and urinary retention. The patient was 14 weeks and 3 days pregnant and presented several week history of urinary frequency and sensation of incomplete bladder emptying. Examination revealed a retroflexed uterus with cervical opening pointing toward the anterior abdominal wall. An ultrasound revealed a thin, elongated maternal bladder and a uterus incarcerated between the sacral promontary and the pubis. The incarceration was successfully reduced by tenaculum traction of the cervical posterior lip without surgical intervention and had a normal infant of appropriate weight at term.