Uterine rupture; An obstetric tragedy still with us. A six year review of cases in a specialist hospital, NorthWest Nigeria

B. A. Mohammed, A. Oyaramade, A. Ogunlaja, I. Ogunlaja
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Abstract

Background: Uterine rupture is a major cause of perinatal and maternal morbidity and mortality, it usually has a devastating outcome if not promptly  attended to. The study determined the trends, risk factors, feto-maternal outcomes following uterine rupture as seen at ASYBSH. Method: The study was a retrospective review of cases of uterine rupture managed at the ASYBSH between March 2015 and February 2021. Records of  the theatre and labour wards were searched and the folders of patients with uterine rupture were retrieved. Relevant information such as socio-  demographic variables, booking status, clinical presentations were retrieved and entered into a structured profoma. Results: Deliveries in the hospital during the period were eleven thousand four hundred and twenty (11,420), out of which one hundred and fifty-six (156)  were complicated by uterine rupture giving an overall incidence of 1.36 percent or one in every seventy-four (74) deliveries. Uterine rupture  occurred mainly among women of low socio-economic status and high parity. The major predisposing factors were injudicious use of oxytocin (62.8%)  prolonged obstructed labour (19.8%), previous caesarean section scar (8.5%), use of misoprostol (5.3%), fundal pressure (2.4%) and unexplained factors  (1.2%) Conclusion: Uterine rupture remains a devastating obstetric calamity with a high incidence. Injudicious use of oxytocin, prolonged obstructed labour and  previous caesarean section scar were the three leading predisposing factors identified in this study.
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子宫破裂;一场产科悲剧仍然伴随着我们。尼日利亚西北部一家专科医院的六年病例审查
背景:子宫破裂是围产期和孕产妇发病和死亡的主要原因,如果不及时处理,通常会造成毁灭性的后果。该研究确定了在ASYBSH观察到的子宫破裂后的趋势、危险因素、胎母结局。方法:回顾性分析2015年3月至2021年2月在ASYBSH治疗的子宫破裂病例。查阅产房、手术室记录,检索子宫破裂患者资料。相关信息,如社会人口统计变量,预约状态,临床表现被检索并输入到一个结构化的profoma中。结果:在此期间在医院分娩11,420例(11,420例),其中156例(156例)合并子宫破裂,总发生率为1.36%,即每74例(74例)分娩1例。子宫破裂主要发生在社会经济地位低、胎次高的妇女中。主要诱发因素为催产素使用不当(62.8%)、难产时间延长(19.8%)、既往剖宫产疤痕(8.5%)、米索前列醇使用(5.3%)、子宫底压力(2.4%)和不明原因因素(1.2%)。结论:子宫破裂仍是一种发生率较高的破坏性产科灾难。不明智地使用催产素,长时间难产和以前的剖腹产疤痕是本研究确定的三个主要诱发因素。
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