RESUMO
A three years study from January 1993 to December 1995 was carried out in the Department of Obstetrics and Gynaecology, Bolan Medical College, Quetta, to study the incidence, risk factors appropriate operative management and fetal outcome in cases of rupture of the gravid uterus. During this period a total of 13072 patients were delivered, out of these 69 had ruptured uterus giving a frequency of 1:189 deliveries. Thirteen patients were having scarred uterus, while uteri of the 56 patients were unscarred. A part from scar common causative factors were obstructed labour due to cephalopeluic disproportion, malpresentation, hydrocephalus, transverse lie and injudicious use of oxytocic drugs in grand multiparas with poor illiterate socioeconomic background. Most of the patients had come from far flung areas of rural Balochistan, where no expert gynaecological help was available. Repair of the uterus with tubal ligation was performed in 39 cases, hysterectomy was performed in 12 cases. Only repair was done in 14 cases keeping in view the parity and site of the tear. Hysterectomy with bladder repair was performed in 4 cases. Maternal mortality was 14.5%. General improvement of overall socioeconomic conditions, availability of improved health services, family planning advice and good supervision during delivery can help in reducing this risk