Title: Retrospective Analytical Study on Spectrum of Antenatal Rupture Uterus Cases Presented in a Tertiary Care Centre

Authors: Dr Pratyaksha Raina, Dr Nupur Nandi, Dr Rehana Nazam

 DOI: https://dx.doi.org/10.18535/jmscr/v8i2.121

Abstract

   

Introduction: Rupture uterus is defined as a full thickness separation of uterus wall and overlying serosa. Various causes attributed are scarred uterus following LSCS, obstructed labor or traumatic. Rupture uterus is a life threatening obstetrics emergency with high maternal and perinatal mortality.

Aim and Objectives aim of study was to critically analyzing all patients presented with rupture uterus and to assess its preventable risk factors, exact presentation and outcome of mother and baby. This was achieved by recording following parameters: To record various presentations of rupture uterus cases, to identify the conditions which could have led to rupture uterus and to study the consequences of rupture uterus for both the mother and the baby.

Methodology: It is a retrospective observational study done between May 2018 - May 2019 in TMMC & RC, Moradabad, Uttar Pradesh .All patients presented with rupture uterus were taken .A detailed history to evaluate various risk factors ,examination  ,its management and intraoperative findings were studied to establish the cause in each case.

Result: Total 17 cases reported with rupture uterus during analysis time period whereas total number of delivery cases were 3336.

My retrospective study confirms important risk factors for uterine rupture which included prior C-section, multiparty, obstructed labour, inappropriate trial& injudicious use of oxytocics.

 The consequence of uterine rupture depend on duration of time that has elapsed from occurrence of rupture until definitive management from supportive & resuscitative measures should be undertaken to prevent consequences, the type of surgical intervention depend upon type, location and extent of uterine rupture.Out of total 17 women who experienced rupture uterus-1 (5.8%) died.

Conclusion: By noticing the strong association of non-utilisation of ANC with rupture uterus cases establishing 100 percent institutional delivery, improving the care and monitoring during labour at each level of health care system and coordination between health care facilities should be a priority for reducing future uterus rupture cases. Also safe prevention of the primary caesarean delivery should be practised to reduce the incidence of rupture uterus.

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