Rupture of gravid uterus

ABSTRACT

To study the maternal morbidity and mortality and fetal outcome in cases of rupture of gravid uterus. Design: Descriptive study. Place and Duration July 2001-June 2004 at Civil Hospital Karachi. Subject And Seventy two women with uterine rupture diagnosed on history, examination and ultrasound scan were included in the study. Outcome measures recorded included parity, gestational age, previous caesarean delivery and its indication, previous evacuation of uterus and nay other uterine surgery induction or augmentation of labour, duration of labour mal presentations, type of delivery and birth weight of baby. 4800 deliveries were conducted over a period of three years. out of which 72 patients had uterine rupture with a prevalence of 1.5%. 46 patients [63.8%] were grand multigravidae and 61 [84.7%] were non booked referrals. Previous caesarean scar was found in 44.5% of patients. 52 patients had a peripartum hysterectomy complication like hypovoemic shock [66.7%], hemorrhage [69.4%] and disseminated intravascular coagulation [25%]. Four maternal deaths occurred Perinatal mortality was 72.2%. Maternal and fetal complications can be avoided and outcome improved by early diagnosis, intensive perioperative monitoring, immediate laparotomy and proper post operative care and management of complications