RUPTURED UTERUS: A PROSPECTIVE STUDY IN EASTERN INDIA

Abstract

INTRODUCTION: Rupture of the gravid uterus is a grave obstetric complication that is associated with high
maternal and perinatal mortality rates. In India, the incidence remains high and continue to increase because of
poverty, illiteracy, unavailability of manpower, poor supply of medical equipment and consumables, and poor
health.
care funding.
OBJECTIVE: To study the cases of rupture uterus in pregnancy by evaluating the risk factors, type and site of
rupture, management, and maternal and perinatal outcome. METHODS: A 3-years prospective observational
study from December 2017 to December 2020 of all cases of ruptured uterus at MKCG Medical College,
Berhampur, Odisha, India. The relevant history, intra-operative findings and postoperative morbidity and mortality
was documented and analysed.
RESULTS: A total of 150 cases of ruptured uterus from 29640 deliveries were recorded, giving an incidence of 5
in 1000. Predisposing or aetiological factors for rupture were prolonged labour (10.66 percent), grand multiparity
(50 percent), injudicious use of oxytocin (4.66 percent), uterine scar (21.33 percent), obstetric manipulation (6
percent) and abnormal lie (7.33 percent). All the patients had surgery, of which 92 (61.33 percent) had total
abdominal hysterectomy, 58 (38.66 percent) had repair of the rupture and bilateral tubal ligation. No maternal
deaths occurred with in the stucy period.
CONCLUSION: Ruptured uterus remains a problem India, with primary health centres and mission houses being
identified as major contributors to this condition. They primarily failed in the recognition of abnormalities in the
antepartum and/or intrapartum periods, with delays in referral and the injudicious use of oxytocin.