Rupture of the pregnant uterus: an analysis of risk factors

ABSTRACT

The purpose of our study was to evaluate the risk factors associated with uterine rupture or dehiscence after caesarean section. We also reviewed the clinical presentation, complications and management of the problem. During the study period there were 28494 deliveries. Among those deliveries there were 24 cases of ruptured and dehiscence of uterine scar. In four cases [16.6%], uterine rupture occurred in an intact uterus. The remaining 20 patients had one or more previous caesarean section delivery. Eight of those patient [33.4%] had uterine rupture, two of them following classical scar and the remaining six patients had two or more transverse caesarean scars. The remaining twelve patients [50%] had dehiscence of the caesarean scars. The remaining twelve patients [50%] had dehiscence of the caesarean section scar. Eighteen patients [75%] of all women who had uterine ruptured were admitted in labour,having had no previous antenatal care. Sixteen patients [66.6%] were grandmultipara. Hysterectomy was performed in 10 [41.6%] patients, while the remaining 14 patients were treated conservatively. In conclusion, we found that the risk of uterine rupture was increased in grandmultipara, in those patients who had no antenatal care, in patients who had classical scare, and in those who gave history of two or more cesarean deliveries