Rupture of gravid uterus still an obstetrical problem: a three year clinical analysis

ABSTRACT

Thirty-five [1.15%] cases of complete rupture of uterus in pregnancy were identified among 3037 deliveries at the Civil Hospital, Karachi between 1993 and 1995. the most common cause [33%] was spontaneous rupture from obstructed labour in multiparas; there were only 2 cases of rupture of uterus in primiparous women. Other common etiological factors were foetopelvic disproportion, foetal malpresentation and contracted pelvis. Rupture of a previously scarred uterus occurred in 15 cases. A previous Caesarean scar [in 13 patients] was not the only predisposing factor-a history of dilatation and curettage [in two patients] and laparotomy for perforation of uterus [in one] were also implicated. Uterine hyperstimulation by oxytocin [3 cases] and unwise obstetrical interference [2 cases] were among the etiological factors. Perinatal mortality was 80% while maternal mortality was 20%. Hysterectomy was performed in 15 [42.86%] cases and repair of the uterus was done when the rupture was small, simple, transverse, in the lower segment and without any sign of infection