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

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.