Ruptured uterus in Enugu, Nigeria

Abstract

Background: Ruptured uterus represents one of the major obstetric emergencies that pose grave danger to both mother and child. It has been shown clearly to contribute significantly to high maternal and perinatal mortality.
Objective: To find out the incidence of ruptured uterus in Enugu, Nigeria, review the types of rupture and factors attributable to the rupture, types of surgeries performed and associated maternal and perinatal outcomes.
Methods: A review of the records of patients with ruptured uterus seen at the University of Nigeria Teaching Hospital (UNTH), Enugu over a five-year period (January 1996-December 2000) was done.
Results: Twenty-seven patients presented with ruptured uterus during the period but records of only 23 cases (85%) were available for analysis. Eighteen of the patients (78.3%) were unbooked. Scar rupture contributed in 13 of the cases (56.5%), spontaneous rupture in 6 (26.1%) and iatrogenic ruptures in 4 cases (17.4%). Subtotal hysterectomy was the commonest surgery, representing 39.1% of the procedures. During the same period, there were 5,074 deliveries giving an incidence of one rupture in 188 deliveries or 5.3/1000. The maternal mortality ratio and perinatal mortality rate were 13,000. per 100,000 and 913 per 1,000 respectively.
Conclusion: The current incidence represents a 2.7 fold rise over a previous study. There was however, a decline in maternal mortality. Reasons for these findings are discussed as well as measures to reduce the high incidence.


Keywords: Ruptured uterus, Rising incidence, Enugu, Nigeria

PHMJ Vol. 2 (2) 2008: pp. 136-139