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ORIGINAL ARTICLE
Year : 2017  |  Volume : 6  |  Issue : 4  |  Page : 251-254

Uterine rupture: A catastrophic obstetric emergency


Department of Gynecology and Obstetrics, Mamata Medical College and General Hospital, Khammam, Andhra Pradesh, India

Correspondence Address:
Dr. K Shaivalini
Department of Gynecology and Obstetrics, Mamata Medical College and General Hospital, Khammam - 507 002, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JDRNTRUHS.JDRNTRUHS_16_14

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Background: Uterine rupture can be a catastrophic obstetrical emergency with high incidence of fetal and maternal morbidity and mortality, varying from 1 in 2000 to1 in 200 deliveries. Aims and objective: To investigate the incidence, etiology, diagnosis, treatment and outcome of uterine rupture. Material and Methods: Thirteen cases of major rupture of the pregnant uterus in which life of the mother and fetus were endangered are presented. This study examined all cases of ruptured uterus managed in the Department of Obstetrics and Gynaecology at Mamata General Hospital, Khammam over a 3 year period. Details were obtained from medical records retrospectively and analyzed manually. Results: All 13 cases had varied etiologies and presentations such as poor antenatal care, previous cesarean section scar was present in 8, uterine anomalies were noted in 3, history of trauma was present in 1 case, and 1 case was grand multipara who set into spontaneous labour. Sonography findings in all cases showed an empty uterus surrounded by echogenic intra-abdominal fluid (haemoperitoneum) with dead fetus and placenta in maternal abdomen. Most patients were in shock and required basic life support, IV fluids, blood transfusion and emergency laparotomy. Few required intensive care and ventilator support. There were no maternal deaths and 100% perinatal deaths were seen. Conclusion: This study confirms previous cesarean section scar as the predominant cause of uterine rupture which can be prevented by regular antenatal care and mandatory institutional delivery.


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