RESUMO
BACKGROUND: Ruptured uterus is a major life-threatening condition encountered mostly in developing countries and is an index of failure of obstetric care at a point in time in a woman's reproductive career. With worsening economic condition, increasing caesarean section rates, and patients' aversion for operative delivery this condition would still remain a major obstetric matter for discussion. OBJECTIVE: To identify the incidence, sociodemographic variables, clinical characteristics, causes, and outcome of ruptured uterus at the University of Port Harcourt Teaching Hospital. MATERIALS AND METHODS: A 5-year retrospective study of cases of ruptured uterus at the University of Port Harcourt Teaching Hospital was carried out. The case notes of 40 patients with uterine rupture during the period 2003-2007 were analyzed. Data collected included sociodemographic characteristics, etiologic factors, clinical presentation, and outcome. Data were analyzed using Microsoft Excel version 2007 and SPSS 14.0 computer software. RESULTS: The incidence of rupture of the gravid uterus was 1:258 deliveries. In patients with rupture of the gravid uterus, 65% (26) of patients were unbooked; 37.5% (15) were aged between 25 and 29 years. A total of 42.5% (17) of patients had secondary education and 21 (52.5%) were housewives. Rupture of a previous scar was the commonest etiologic factor accounting for 32.5% (11). The commonest presentation was abdominal pain in 92.5% of cases. Perinatal mortality and maternal mortality were 80% and 17.5% respectively. CONCLUSION: Rupture of the gravid uterus still remains a major cause of maternal mortality. Injudicious use of oxytocics should be discouraged in peripheral health facilities and reinforcement of the need for hospital based deliveries in patients with previous caesarean sections should also be intensified to improve outcome.
RESUMO
Selective 5-hydroxytryptamine (5-HT) receptor antagonists were employed to further characterize the receptor subtypes mediating the contractile actions of 5-HT on the isolated uterine preparations of the rat. Increasing concentrations (10(-8)-10(-6) M) of the 5-HT receptor antagonist methysergide produced rightward shifts of the concentration-response curves of the 5-HT-induced contractions (pA2=8.05, slope of A-S plot=1.12 n=7) ketanserin a 5-HT2A receptor antagonist (10(-8)-10(-6) M) competitively antagonized the actions of 5-HT on the preparation (pA2=8.81; slope=1.04; n=7). Both LY53857 (10(-8)-10(-6) M) and ICI169369 (10(-8)-10(-6) M) which are known 5-HT2 receptor blockers also produced concentration-dependent shifts of the curves LY53857 yielded a pA2 of 8.9 (slope=0.82; n=7) while the pA2 for ICI169369 on the preparation was 7.9 (slope=1.29; n=7). ICS205930 a potent 5-HT3 blocker (10(-12)-10(-9) M) also produced concentration-dependent shifts of the curves (pA2=11.3; slope=0.94; n=7). The presence of 5-HT1 receptors could not be established. However both 5-HT2 and 5-HT3 receptors seem to be present on the rat uterine preparation.
