Complete Uterine Rupture a Stigma for Modern Obstetrics: An Observational Study

Abstract

To know the and maternal and perinatal outcome in women with complete uterine rupture. Background: Uterine rupture is a catastrophic obstetric event associated with high maternal, perinatal morbidity and mortality. Objectives: The present study was conducted to know prevalence, risk factors, presentation, maternal, perinatal outcome in women with complete uterine rupture. Present retrospective observational study was conducted on 31 women admitted to Obstetrics ward of rural tertiary center of Northern India with complete uterine rupture between January 2016 and December 2018 after Institutional ethical committee approval and informed written consent from participants. Data included socio-demographic parameters, gestation, predisposing factors, clinical features, site of rupture, associated bladder injury, need for hysterectomy, perinatal and maternal outcome. Statistical analysis was done using Statistical Package for the Social Sciences software version 22.0. Of total 9,156 deliveries during study period 31 women had uterine rupture, indicating prevalence of 0.34%. Of all, 21(67.7%) women had unscarred uterine rupture and 10(32.3%) scarred uterine rupture. Majority cases were un-booked (77.4%), multiparous (90.3%) and term at gestation (66.7%) with an average age of all cases as 26.97±3.73 years. Most common risk factor was injudicious use of oxytocic (29.0%) and previous cesarean section scar (22.6%). Most common site of unscarred uterine rupture was lower uterine segment (26.7%) and in scarred uterus, site of previous cesarean section (26.7%). Eight (25.8%) women had bladder injury. Total 24(77.4%) fetuses were stillborn. Seventeen (54.8%) women needed hysterectomy as lifesaving procedure and three (9.7%) succumbed to death despite of all resuscitative measures. Hence, complete uterine rupture is common in rural areas and is serious obstetric emergency with high perinatal, maternal morbidity and mortality. Other: As most of the cases of complete uterine rupture occur in unbooked women, hence, motivating all antenatal women for regular antenatal visits can prevent the dreadful condition to a large extent, thereby saving many maternal and fetal lives.