Second trimester uterine rupture: lesson learned

JPMA. The Journal of the Pakistan Medical Association, 2011

To determine the frequency, predisposing factors and maternal and foetal outcome of uterine rupture. This descriptive case series was conduced at the Department of Gynaecology and Obstetrics, Liaquat University of Medical & Health Sciences, Jamshoro from January 2008 to December 2008. All cases of ruptured uterus, who were either admitted with this complication or who developed it in the hospital, were included in the study. Patients having ruptured uterus due to congenital abnormality were excluded from the study. Demographic data, details of predisposing factors, type of rupture, the management, maternal and foetal outcome were taken into consideration for analysis. Data was analyzed using SPSS version 10.0. The total number of deliveries during the year January to December 2008 was 2010. There were 15 cases (0.74%) of uterine rupture. Out of these only three (20%) were booked. Most of the patients (60%) presented between the ages 26-30. Majority of uterine rupture occurred in par...

International Journal of Gynecology & Obstetrics, 1995

Objectives: To investigate the frequency of ruptured uterus, possible etioiogic factors and fetomaternal outcomes. Metho&: The birth records of 58 262 deliveries at Dr Zekai Tahir Burak Women's Hospital from 1 January 1990 to 31 December 1992 were reviewed and the results compared with those of two previous studies reported from this hospital on the same subject. Results: Forty uterine ruptures occurred between 1990 and 1992, with a frequency of 0.068% (l/1457). All occurred spontaneously but 10 (25%) had no previous surgery, whereas 30 followed previous cesarean section. There was no traumatic uterine rupture during this period. Fetal mortality was 32.5% and no maternal deaths were recorded. Conclusion: The rate of ruptured uterus has declined among our hospital population as etiologic factors responsible for the complication have been reduced.

International Journal of Reproduction, Contraception, Obstetrics and Gynecology

Background: Between January 2001 to September 2003, 46,171 deliveries were recorded, the number of caesarean deliveries during this period of two years and nine months were 16,182 (35.04%). Methods: An Audit from the Institute of obstetrics and gynecology, of uterine ruptures.Results: Total 81 cases of uterine rupture were managed at the Institute. Total number of scar ruptures managed were, 48/81 uterine ruptures. Five women had previous classical upper segment caesarean, and in previous lower segment caesarean section (LSCS), there were 43 cases of rupture uterus. In two cases following forceps delivery, traumatic uterine ruptures were recorded. Spontaneous ruptures were 31 during the study period. Bladder rupture occurred in 13 cases, 16.04% of uterine ruptures. The fetal outcome in uterine ruptures 81 cases, live births were 19-23.45%. The number of vaginal births after caesarean section were 261, 215, 186 in the years 2001, 2002 and 2003 at the Institute of obstetrics and gyn...

International Journal of Reproduction, Contraception, Obstetrics and Gynecology

Background: Uterine rupture is undoubtedly one of the most tragic events that can occur in a women’s life and tragedy becomes more grim when she is young. In India, in advanced cities the incidence of rupture preceded by obstructed labour is decreasing, in rural parts where there is inadequate care, lack of communication and transport, home deliveries by untrained dais incidence of rupture uterus is still high. So, the study is to evaluate the etiological factors, incidence, management modalities and maternal and perinatal outcome.Methods: A prospective cross-sectional study of 46 cases of rupture uterus and maternal and Perinatal outcome, in the department of Obstetrics and Gynecology in government tertiary reference center.Results: Overall incidence of uterine rupture is 1 in 924. Out of 46 cases 07 (15.22%) were booked, and 39 (84.78%) were referred patients. The 20-30 years age group is the most vulnerable age group. Out of 44 rupture uterus during labor, 13 (22.72%) were sponta...

Aim and Objective: The present research was carried out with an objective to determine the incidence, etiology, trend, and management, maternal and fetal outcome of ruptured uterus and to identify the preventive measures. Material and Methods: A prospective observational study was conducted over a period of 2 years from Nov 2012 – Nov 2014 in a tertiary care hospital of Mumbai, India. A total of 40 patients who came with rupture of uterus in pregnancy were studied. These cases were analyzed based on clinical features, etiology and risk factors of rupture uterus, the mode of management and the foetal and maternal outcome. Results: There were 40 cases of uterine rupture out of 32,200 deliveries giving an incidence of 1 in 805 i.e. 0.12%. Most common clinical features were those of classical signs of rupture with ill defined uterine contour, superficially felt foetal parts and absent foetal heart sounds. The commonest cause of rupture was due to separation of previous cesarean scar rupture (72.5%). The lower uterine segment was the commonest site of rupture. Rent repair was the commonest procedure done in the cases of ruptured uterus. Perinatal mortality of 77.5% and maternal mortality of 10% was observed in this study. Conclusion: Skilled attendance with accessible emergency obstetric care and focused antenatal care are key elements for the prevention and management of uterine rupture.

Journal of SAFOG with DVD, 2012

Objectives To determine the impact of improved obstetric care on the incidence, risk factors, management modalities and fetomaternal outcome of uterine rupture. Materials and methods Retrospective analysis of clinical records of uterine rupture cases at the department of Obstetrics and Gynecology, Abha General Hospital, Abha, KSA, from January 2007 to January 2012. Outcome measures Maternal and perinatal morbidity and mortality. Results Analysis showed 33 cases of uterine rupture among 34,590 deliveries, the incidence being 1/1048 (0.09%). Majority of the cases (73%) were unbooked. Important risk factors were previous cesarean section (88%) and grand multiparity (80%). Previous one C-section was also found to be an important risk factor (80%) for uterine rupture. Most of the patients were in their 30s. The frequency of complete and incomplete uterine rupture was almost the same (52 and 48% respectively). Total abdominal hysterectomy was required in 9 (27%), repair in 23 (70%) and on...

The Malaysian journal of medical sciences : MJMS, 2014

Uterine rupture is a rare life-threatening complication. It mainly occurs in the third trimester of pregnancy and is rarely seen during the first or second trimesters. Our centre experienced three important cases of uterine rupture. spontaneous uterine rupture at 14 weeks of pregnancy, which was diagnosed at autopsy. It was misled by the ultrasound finding of an intrauterine pregnancy, and searching for other non-gynaecological causes delayed the urgent obstetric surgical management. ruptured uterus at 24 weeks following medical termination due to foetal anomaly. It was diagnosed only at laparotomy indicated for failed medical termination and chorioamnionitis. Third case: uterine rupture at 21 weeks of pregnancy in a patient with gastroenterology symptoms. In these reports, we have discussed the various risk factors, presentations, course of events and difficulties in diagnosing uterine rupture. The study concludes that the clinical presentation of uterine ruptures varies. It occurs...

Faridpur Medical College Journal, 2013

Rupture uterus is a rare and often catastrophic condition. It is associated with a high incidence of fetal and maternal mortality and morbidity. Our objective in this study is to determine incidence, etiology, trend, management, maternal and fetal outcome of uterine rupture in Faridpur Medical College Hospital. This is a prospective cross-sectional study of patients with ruptured uterus from the period of January 2011 to December 2011 admitted at Faridpur Medical College Hospital. All the cases of ruptured uterus who were either admitted with uterine rupture or who developed it in hospital were included in the study. Patients having ruptured uterus due to congenital anomaly were excluded from the study. Patients were initially assessed in labour ward, relevant sociodemographic data, previous antenatal and surgical history recorded. Ways of management, maternal and fetal outcome were taken for analysis. There were 30 cases of ruptured uterus out of total 3606 deliveries (includin...

2014

OBJECTIVE: Presenting a case of uterine rupture as early as 20 weeks of gestation after classical caesarian section done with short inter pregnancy duration and inter delivery duration of 9 months. CASE: 26 years old women gravida 2, para 1, and Death 1 with 20 weeks gestation with history of classical c-section done 9 months back in rural area (Bihar) for IUFD (cause not known) presented to out-patient department with abdominal pain, uterine contraction & severe scar tenderness present. Patient was sent for USG and she followed up in OPD within an hour with the USG report showing single live intrauterine pregnancy of 19 weeks and 5 days and told that her pain had subsided. Suspecting a uterine rupture a repeat USG was done which showed a totally different picture suggesting 3.2 cm rupture in the anterior wall with protrusion of fetal parts, limb in the anterior pouch, with amniotic fluid surrounding it. FHS was present/ irregular. No liquor in uterine cavity, No Hemoperitoneum. Cer...

2020

Background:Uterine rupture is a rare obstetrical complication associated with disastrous outcome. Since the rate of caesarean deliveries has increased in the past decades, the risk of scar rupture is also expected to increase. The incidence of uterine rupture is inversely proportional to quality of obstetric care being provided. In the developing world, uterine rupture can have devastating maternal and/or fetal outcomes due to delayed recognition and/or intervention Materials and Methods:This is a retrospective study of patients with uterine rupture from January 2017 to December 2017, admitted in Rajendra Institute of Medical Sciences, Ranchi in the Department of Obstetrics and Gynecology. All the cases of uterine rupture were included and detailed study of their case history, obstetric history, surgical history was done. Details of their referral, duration & augmentation of labor, diagnosis on admission, site of rupture, surgical intervention requiring hysterectomy or repair and fe...