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Uterine Rupture: a Major Contributor to Obstetric Morbidity in Sagamu
Abstract
Objectives:To determine the incidence, aetiology and the associated morbidity and mortality in cases of ruptured uterus presenting at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
Materials and Methods: A review of all the case notes of patients that were managed for uterine rupture over a 7-year period was conducted. The records were analysed for the patients' mode of presentation, possible predisposing factors, type of uterine rupture, and the associated morbidity and mortality.
Results: The incidence of rupture during the period was 1 in 67 deliveries or 14.9 per 1000 deliveries. The mean age [SD] was 30.1 [1.8] and the mean parity was 3.3 [0.93]. Majority (88.5%) of the patients were unbooked. Oxytocin administration was the identified aetiological factor in 41 (67.2%) of the patients. Majority (73.8%) presented with clinical signs of shock. At operation, 56 (91.8%) were found to have complete uterine rupture, with a predominance of anterior wall rupture (83.6%). Uterine repair with or without bilateral tubal ligation was the usual surgical treatment offered while wound sepsis, with or without generalized septicaemia, was the commonest morbidity found. Maternal mortality was 14.8%.
Conclusion: Uterine rupture continues to be a major cause of maternal morbidity and mortality in Sagamu and efforts should be geared towards reducing the number of women affected by this problem.
Key Words: Uterus Rupture, Genital Injury, Haemorrhage, Shock
[Trop J Obstet Gynaecol, 2003, 20: 137-140]
