Rupture of the gravid uterus in a referral hospital in Niger Republic: results of a two year prospective study

Abstract

Background: Rupture of the gravid uterus is a major cause of maternal and perinatal morbidity and mortality in developing countries.
Methods: A review of the clinical records of all cases of ruptured uterus managed at the Center Hospitalier Regional, Dosso, Niger Republic, between January 2000 and December 2001 were carried out. The records were analyzed for age, parity and aetiological factors, operative findings/type of surgery, complication and outcome
Results: During this period, seventy-seven cases of uterine rupture were managed at the hospital. The total number of hospital deliveries was 3,512 giving an incidence of 1 in 46 deliveries for ruptured uterus. There were 7 maternal deaths as a result of uterine rupture representing 10.6% of the total maternal deaths. The commonest associated factor was obstructed labour. Transverse lower segment was the commonest site. Repair of the rupture site and sterilization was the preferred surgical treatment followed by repair only and then hysterectomy. The commonest maternal complications were anemia, vesico-vaginal fistula, wound sepsis and septicaemia
Conclusion: Provision of emergency obstetric care, qualitative antenatal care, health education for the populace and labour supervision by trained personnel are suggested ways of preventing this obstetric calamity

Key words: Uterine rupture, Obstructed labour, Uterine repair, Hysterectomy,