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Erschienen in: Archives of Gynecology and Obstetrics 3/2011

01.03.2011 | Materno-fetal Medicine

Uterine rupture in pregnancy: a five-year study

verfasst von: Anjali Gupta, Smiti Nanda

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 3/2011

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Abstract

Background

Uterine rupture during pregnancy is a rare occurrence that frequently results in high incidence of maternal and fetal morbidity and mortality.

Aim

To study the incidence, risk factors, maternal and fetal outcome of uterine rupture.

Study design

A retrospective study.

Methods

A retrospective study was carried out in the Department of Obstetrics and Gynecology in a tertiary health care center. The cases of uterine rupture whether booked or unbooked that were received and managed in the hospital over a period of 5 years from January 2002 to December 2006, were included in the study.

Results

The total number of uterine rupture cases was 57 out of 33,394 deliveries. The incidence of uterine rupture was 0.17%. Majority of the patients belonged to age group 30–34 years and were multiparas. Most of the cases were due to obstructed and neglected labor (52.63%), 35.08% due to scar rupture and 8.77% were due to uterine trauma. The bladder injuries were found in 8.77%. Repair of the uterine rent was possible in 70.18% (40/57) cases. Hysterectomy was done in 29.82% cases. Stillbirths were observed in 94.74% of women with uterine rupture. There was no maternal mortality.

Conclusions

The leading cause of uterine rupture was found to be neglected and obstructed labor due to mismanagement by local untrained birth attendants. Timely recognition and referral to higher centers can reduce the maternal and fetal morbidity and mortality due to uterine rupture.
Literatur
1.
Zurück zum Zitat Saglamtas M, Vicdan K, Yalcin H, Yilmaz Z, Yesilyurt H, Gokmen O (1995) Rupture of the uterus. Int J Gynaecol Obstet 49:9–15CrossRefPubMed Saglamtas M, Vicdan K, Yalcin H, Yilmaz Z, Yesilyurt H, Gokmen O (1995) Rupture of the uterus. Int J Gynaecol Obstet 49:9–15CrossRefPubMed
2.
Zurück zum Zitat Miller DA, Goodwin TM, Gherman RB, Paul RH (1997) Intrapartum rupture of unscarred uterus. Obstet Gynecol 89:671–673CrossRefPubMed Miller DA, Goodwin TM, Gherman RB, Paul RH (1997) Intrapartum rupture of unscarred uterus. Obstet Gynecol 89:671–673CrossRefPubMed
3.
Zurück zum Zitat Gardeil F, Daly S, Turner MJ (1994) Uterine rupture in pregnancy reviewed. Eur J Obstet Gynecol Reprod Biol 56:107–110CrossRefPubMed Gardeil F, Daly S, Turner MJ (1994) Uterine rupture in pregnancy reviewed. Eur J Obstet Gynecol Reprod Biol 56:107–110CrossRefPubMed
4.
Zurück zum Zitat Konje JC, Odukoya OA, Ladipo OA (1990) Ruptured uterus in Ibadan: a twelve year review. Int J Gynaecol Obstet 32:207–213CrossRefPubMed Konje JC, Odukoya OA, Ladipo OA (1990) Ruptured uterus in Ibadan: a twelve year review. Int J Gynaecol Obstet 32:207–213CrossRefPubMed
5.
Zurück zum Zitat Ezechi OC, Mabayoje P, Obiesie LO (2004) Ruptured uterus in South Western Nigeria: a reappraisal. Singap Med J 45:113–116 Ezechi OC, Mabayoje P, Obiesie LO (2004) Ruptured uterus in South Western Nigeria: a reappraisal. Singap Med J 45:113–116
6.
Zurück zum Zitat Ola ER, Olamijulo JA (1998) Rupture of the uterus at the Lagos University Teaching Hospital, Lagos, Nigeria. West Afr J Med 17:188–193PubMed Ola ER, Olamijulo JA (1998) Rupture of the uterus at the Lagos University Teaching Hospital, Lagos, Nigeria. West Afr J Med 17:188–193PubMed
7.
Zurück zum Zitat Cunningham FG, Gilstrap LC III, Vandorsten JP (2002) Operative obstetrics, 2nd edn. McGraw–Hill, USA, pp 223–241 Cunningham FG, Gilstrap LC III, Vandorsten JP (2002) Operative obstetrics, 2nd edn. McGraw–Hill, USA, pp 223–241
8.
Zurück zum Zitat Hofmeyr GJ, Say L, Gulmezoqlu AM (2005) WHO systematic review of maternal mortality and morbidity: the prevalence of uterine rupture. BJOG 112:1221–1228CrossRefPubMed Hofmeyr GJ, Say L, Gulmezoqlu AM (2005) WHO systematic review of maternal mortality and morbidity: the prevalence of uterine rupture. BJOG 112:1221–1228CrossRefPubMed
9.
Zurück zum Zitat Yap OW, Kim ES, Laros RK Jr (2001) Maternal and neonatal outcomes after uterine rupture in labor. Am J Obstet Gynecol 184:1576–1581CrossRefPubMed Yap OW, Kim ES, Laros RK Jr (2001) Maternal and neonatal outcomes after uterine rupture in labor. Am J Obstet Gynecol 184:1576–1581CrossRefPubMed
10.
Zurück zum Zitat Dow M, Wax JR, Pinette MG, Blackstone J, Cartin A (2009) Third-trimester uterine rupture without previous cesarean: a case series and review of the literature. Am J Perinatol 26:739–744CrossRefPubMed Dow M, Wax JR, Pinette MG, Blackstone J, Cartin A (2009) Third-trimester uterine rupture without previous cesarean: a case series and review of the literature. Am J Perinatol 26:739–744CrossRefPubMed
11.
Zurück zum Zitat Gessessew A, Melese MM (2002) Ruptured uterus—eight year retrospective analysis of causes and management outcome in Adigrat Hospital, Tigray region, Ethiopia. Ethiop J Health Dev 16:241–245 Gessessew A, Melese MM (2002) Ruptured uterus—eight year retrospective analysis of causes and management outcome in Adigrat Hospital, Tigray region, Ethiopia. Ethiop J Health Dev 16:241–245
12.
Zurück zum Zitat Ebeigka PN, Enabudosa E, Ande EB (2005) Ruptured uterus in a Nigerian community: a study of sociodemographic and obstetric risk factors. Acta Obstet Gynecol Scand 84:1172–1174 Ebeigka PN, Enabudosa E, Ande EB (2005) Ruptured uterus in a Nigerian community: a study of sociodemographic and obstetric risk factors. Acta Obstet Gynecol Scand 84:1172–1174
13.
Zurück zum Zitat Dhar G (1989) Rupture of the uterus. In: Rao KB (ed) Postgraduate obstetrics and gynecology, 4th edn. Orient Longman, Chennai, pp 192–197 Dhar G (1989) Rupture of the uterus. In: Rao KB (ed) Postgraduate obstetrics and gynecology, 4th edn. Orient Longman, Chennai, pp 192–197
14.
Zurück zum Zitat Ekanem EI, Etuk SJ, Ekott MI, Ekabua JE, Iklabi C (2008) Socio demographic profile and presentations of patients with ruptured gravid uterus in Calabar, Nigeria. Niger J Med 17:78–82PubMed Ekanem EI, Etuk SJ, Ekott MI, Ekabua JE, Iklabi C (2008) Socio demographic profile and presentations of patients with ruptured gravid uterus in Calabar, Nigeria. Niger J Med 17:78–82PubMed
15.
Zurück zum Zitat Fabamwo A, Akinola O, Tayo A, Akpan E (2009) Rupture of the gravid uterus: a never-ending obstetric disaster! The Ikeja experience. Internet J Gynecol Obstet 10 Fabamwo A, Akinola O, Tayo A, Akpan E (2009) Rupture of the gravid uterus: a never-ending obstetric disaster! The Ikeja experience. Internet J Gynecol Obstet 10
16.
Zurück zum Zitat Zeteroglu S, Ustun Y, Engin-Ustun Y, Sahin G, Kamaci M (2005) Eight years, experience of uterine rupture cases. J Obstet Gynaecol 25:458–461CrossRefPubMed Zeteroglu S, Ustun Y, Engin-Ustun Y, Sahin G, Kamaci M (2005) Eight years, experience of uterine rupture cases. J Obstet Gynaecol 25:458–461CrossRefPubMed
17.
Zurück zum Zitat Zwart JJ, Richters JM, Ory F, De Vries JI, Bloemenkamp KW, Van Roosmalen J (2009) Uterine rupture in the Netherlands: a nationwide population-based cohort study. BJOG 116:1069–1078CrossRefPubMed Zwart JJ, Richters JM, Ory F, De Vries JI, Bloemenkamp KW, Van Roosmalen J (2009) Uterine rupture in the Netherlands: a nationwide population-based cohort study. BJOG 116:1069–1078CrossRefPubMed
18.
Zurück zum Zitat Nagarkatti RS, Ambiya VR, Vaidya PR (1991) Rupture uterus: changing trends in etiology and management. J Postgrad Med 37:136–139PubMed Nagarkatti RS, Ambiya VR, Vaidya PR (1991) Rupture uterus: changing trends in etiology and management. J Postgrad Med 37:136–139PubMed
19.
Zurück zum Zitat Mokgokong GT, Marivate M (1976) Treatment of the ruptured uterus. S Afr Med J 50:16–21 Mokgokong GT, Marivate M (1976) Treatment of the ruptured uterus. S Afr Med J 50:16–21
20.
Zurück zum Zitat Chen LH, Tan KH, Yeo GS (1995) A ten year review of uterine rupture in modern obstetric practice. Ann Acad Med Singap 24:830–835PubMed Chen LH, Tan KH, Yeo GS (1995) A ten year review of uterine rupture in modern obstetric practice. Ann Acad Med Singap 24:830–835PubMed
21.
Zurück zum Zitat Chew SY (1984) Uterine rupture in labour. A 10-year review. Singap Med J 25:24–29 Chew SY (1984) Uterine rupture in labour. A 10-year review. Singap Med J 25:24–29
22.
Zurück zum Zitat Khan S, Parveen Z, Begum S, Alam I (2003) Uterine rupture: a review of 34 cases at Ayub Teaching Hospital, Abbottabad. J Ayub Med Coll Abbottabad 15:50–52PubMed Khan S, Parveen Z, Begum S, Alam I (2003) Uterine rupture: a review of 34 cases at Ayub Teaching Hospital, Abbottabad. J Ayub Med Coll Abbottabad 15:50–52PubMed
23.
Zurück zum Zitat Onwuhafua P, Onwuhafua A, Omekara D, Ibrahim R (1998) Ruptured uterus in Kaduna, Nigeria: a six year review. J Obstet Gynaecol 18:419–423CrossRefPubMed Onwuhafua P, Onwuhafua A, Omekara D, Ibrahim R (1998) Ruptured uterus in Kaduna, Nigeria: a six year review. J Obstet Gynaecol 18:419–423CrossRefPubMed
24.
Zurück zum Zitat Al Salem MH, Makhseed M, Ahmed MA, Gupta M (2000) Rupture of the gravid uterus: experience of the maternity hospital, Kuwait. Med Princ Pract 9:97–105CrossRef Al Salem MH, Makhseed M, Ahmed MA, Gupta M (2000) Rupture of the gravid uterus: experience of the maternity hospital, Kuwait. Med Princ Pract 9:97–105CrossRef
25.
Zurück zum Zitat Ozdemir I, Yucel N, Yucel O (2005) Rupture of the pregnant uterus: a 9-year review. Arch Gynecol Obstet 272:229–231CrossRefPubMed Ozdemir I, Yucel N, Yucel O (2005) Rupture of the pregnant uterus: a 9-year review. Arch Gynecol Obstet 272:229–231CrossRefPubMed
26.
Zurück zum Zitat Rao KB (1999) Obstructed labour. In: Ratnam SS, Rao KB, Arulkumaran S (eds) Obstetrics and gynecology for postgraduates, 2nd edn. Orient Longman, Chennai, pp 139–144 Rao KB (1999) Obstructed labour. In: Ratnam SS, Rao KB, Arulkumaran S (eds) Obstetrics and gynecology for postgraduates, 2nd edn. Orient Longman, Chennai, pp 139–144
27.
Zurück zum Zitat Dhaifalah I, Santavy J, Fingerova H (2006) Uterine rupture during pregnancy and delivery among women attending the Al-Tthawra hospital in Sana, a city Yemen Republic. Biomed Pap Med Fac Palacky Olomouc Czech Repub 150:279–283 Dhaifalah I, Santavy J, Fingerova H (2006) Uterine rupture during pregnancy and delivery among women attending the Al-Tthawra hospital in Sana, a city Yemen Republic. Biomed Pap Med Fac Palacky Olomouc Czech Repub 150:279–283
28.
Zurück zum Zitat Nkata M (1996) Rupture of the uterus: a review of 32 cases in a general hospital in Zambia. BMJ 312:1204–1205PubMed Nkata M (1996) Rupture of the uterus: a review of 32 cases in a general hospital in Zambia. BMJ 312:1204–1205PubMed
29.
Zurück zum Zitat Sinha J, Roy S (1986) A retrospective study of rupture uterus at Patna Medical College Hospital during five year period 1978–1982. J Obstet Gynecol India 36:241–245 Sinha J, Roy S (1986) A retrospective study of rupture uterus at Patna Medical College Hospital during five year period 1978–1982. J Obstet Gynecol India 36:241–245
30.
Zurück zum Zitat Kulkarni NP, Kendre BV (1990) Rupture uterus—experience at a rural medical college. J Obstet Gynecol India 40:75–79 Kulkarni NP, Kendre BV (1990) Rupture uterus—experience at a rural medical college. J Obstet Gynecol India 40:75–79
31.
Zurück zum Zitat Al Sakka M, Hamsho A, Khan L (1998) Rupture of the pregnant uterus—a 21-year review. Int J Gynaecol Obstet 63:105–108CrossRefPubMed Al Sakka M, Hamsho A, Khan L (1998) Rupture of the pregnant uterus—a 21-year review. Int J Gynaecol Obstet 63:105–108CrossRefPubMed
32.
Zurück zum Zitat Walsh CA, Baxi LV (2007) Rupture of the primigravid uterus: a review of the literature. Obstet Gynecol Surv 62:327–334CrossRefPubMed Walsh CA, Baxi LV (2007) Rupture of the primigravid uterus: a review of the literature. Obstet Gynecol Surv 62:327–334CrossRefPubMed
Metadaten
Titel
Uterine rupture in pregnancy: a five-year study
verfasst von
Anjali Gupta
Smiti Nanda
Publikationsdatum
01.03.2011
Verlag
Springer-Verlag
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 3/2011
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-010-1357-9

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