Maternal & Foetal out Come In Rupture of Uterine Scar During Term Labour.
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Abstract
Objective:
1. Determine the maternal morbidity and mortality associated with uterine rupture.
2. Observe the foetal outcome associated with uterine rupture.
Study Design: Case Series
Place & Duration Of Study: All gynecological and obstetrical unit of Liaquat University Hospital, Hyderabad for
two years Study with effect from 01-01-2006 to 31-12-2007
Methodology: 50 patients diagnosed to be ruptured of uterine scar during term labour were included in this
study on the basis of non probable-Purposive sampling. These patients were diagnosed by clinical examinations
and diagnosis was confirmed on laparotomy after resuscitation and relevant investigations.
Results: The average age of patient was (33) range ( 20 – 40). Hysterectomy was done in 15 (30%) patients, out
of which subtotal hysterectomy was done in 10 cases (20%) and total hysterectomy in 5 patients (10%). Repair
was done in 35 patients (70%). Operative and post operative complications. Fifteen patients (30%) developed
sound infection. Five patients (10%) developed severe peritonitis. Three patients (6%) developed vesico vaginal
fistula. Two patients (4%) developed pneumonia. One patients (2%) developed renal failure due to hemorrhage.
One patient (2%) developed generalized sepsis. One patients (2%) developed thromboembolic complication.
Two maternal deaths (4%) occurred were due to severe maternal hemorrhage.
48 babies (96%) were stillbirths.
Conclusions: Rupture of gravid uterus is a life threatening emergency requiring immediate surgical intervention
with more than 95% feotal deaths and Injudicious use of oxytocin by Dais/ TBAS was the most common cause of
ruptured uterus.
High parity, illiteracy, ignorance coupled with inadequate maternity service, lack of antepartum and intraprtum
care, prior caesarean delivery were identified as risk factors for uterine rupture, its occurrence is usually associated with considerable maternal and fetal mortality and morbidity.
Keywords: Uterine Rupture, Hysterectomy, Traditional Birth attendance.
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