Analysis of uterine ruptures in pregnancy in a Tertiary Care Institute
Journal Title: Medpulse International Journal of Gynaecology - Year 2017, Vol 4, Issue 3
Abstract
Aim and objectives: To calculate proportion of uterine rupture in pregnancy, analyze the maternal outcome and study the risk factors of uterine rupture. Material and methods: A retrospective observational study with review of case records was performed at MGM Medical College and Hospital, Aurangabad over a period of 2 years from October 2015 to October 2017. Results: Uterine rupture was a rare entity with proportion of 0.125%. 75% patients were referred from outside while 25% didn’t receive antenatal care.50% patients presented before the age of viability with 12.5% patient having history of illegal MTP. 75% patients were multigravida while 12.5% were grandmultigravida and primigravida each. Only 12.5% were asymptomatic at presentation, 25% had pain in abdomen, 25% bleeding per vagina while 37.5% had presented in shock. 50% had history of previous uterine scar( all due to previous LSCS). 12.5% had unicornuate and bicornuate uterus each. Significant fetal mortality was seen. Only 25% live births occurred. 25% were intrauterine fetal demise (IUFD).12.5% foetus were lying inside the abdominal cavity. 75% patients underwent conservative surgery and 25% required subtotal hysterectomy. Prolonged catheterization was required in 25% patients due to dense bladder adhesions. All patients were managed in High dependency unit (HDU). 12.5% maternal mortality was observed. Conclusion: There is high risk of maternal and fetal morbidity and mortality. Risk factors were enumerated which can be considered as a check list while managing a patient who is at high risk for uterine rupture or perforation. If multiple risk factors are seen in a single patient, then precaution should be taken to prevent rupture.
Authors and Affiliations
Meenal Chugh, Shubhangi Mande, Swati Shiradkar
Keywords
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