Rupture of previously scarred uterus: a preventable catastrophy

ABSTRACT

A study was carried out on 50 cases of rupture of a previously scarred uterus to determine causative factors and to discuss preventive aspects. Rupture occurred more frequently in 33 [66%] cases who had had Caesarean section previously for cephalopelvic disproportion and/or failure to progress. Thirty-six [72%] Caesarean sections had been done at non-teaching institutions. Some intra-or post-operative problems were encountered in 28 [56%] patients during previous surgery. In 22 [44%] cases labour was well established at the time of presentation and 16 [32%] patients came with a classical clinical picture rupture. Evidence of outside interference was documented in 39 [78%] cases. Preventive measures emphasized are to perform Caesarean section only it genuinely indicated and to impart essential health education to the scarred obstetric population regarding management of subsequent pregnancies. It is also important that personnel engaged in the maternal health care system must be trained adequately so that they can properly handle patients with previous scars