A retrospective study of causes and outcome of ruptured uterus in a rural medical college hospital of north east Bihar, India
Journal Title: Medpulse International Journal of Gynaecology - Year 2017, Vol 3, Issue 1
Abstract
Background: Ruptured uterus is a common cause of maternal and perinatal mortality and morbidity. Further studies may help in the development of preventive strategies. Objective: To determine the frequency, cause and management outcome of ruptured uterus at a regional hospital. Method: A retrospective study was done to describe the frequency, cause, treatment, complications, and maternal and fetal mortality associated with ruptured uterus. Astructured questionnaire was used to collect information from delivery registration books, operation room records, and patient cards. Results: A total of 64 cases of ruptured uterus and 4,180 hospital deliveries were recorded for a ratio of 1:65.Causes of rupture were: cephalo-pelvic disproportion (51.5%), malpresentation and malposition (26.56%),instrumental (3.1%), oxytocin induced (3.1%), uterine scar (14.0%) and placenta percreta (1.56%). Most were multipara and rupture was complete in 92.3%. The most common site of rupture was the lower segment of the uterus in 35 (54.68%) followed by the left lateral 17 (26.5%), posterior 6 (9.35%), upper segment 4 (6.25%) and right lateral 2 (3.12%). There were 10(18.5%) cases with bladder rupture and all had rupture at the lower uterine segment. Vesico-vaginal fistula and wound infection were common post-operative complications. Maternal case fatality rate was 9.2% and fetal case fatality rate was 95.7%. Ruptured uterus contributed 28% of all causes of maternal deaths in the hospital within the study period. Conclusion: This calls for an integrated effort to prevent the causes of uterine rupture and ensureprompt management to reduce maternal and perinatal mortality and morbidity.
Authors and Affiliations
Swapan Kumar Kundu, Sekhar Chakrabarti, Arpan Chatterjee, Soumyajyoti Kundu
Keywords
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