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Obstetric uterine rupture: a four-year clinical analysis
S M Ziadeh1, M F El-Jallad, E I Sunn'a
1Department of Obstetrics and Gynaecology, Jordan University of Science and Technology, Irbid, Jordan. ziadeh@index.com.jo
Objective:
The purpose of our study was to identify the risk factors of uterine rupture during labour, to report maternal and neonatal outcome, and to propose preventive measures.
Study Design:
A retrospective study with review of patients' files and monitor strips was performed.
Results:
Between January 1, 1994 and November 30, 1998, there were 21 cases of uterine rupture at our institution. Of these, 6 patients had complete rupture, and 15 had incomplete rupture. The risk of uterine rupture was increased in patients who had a history of one or more Caesarean sections, obstructed labour, dysfunctional labour, and those who had injudicious use of uterine stimulants. There was no maternal death and fetal loss was 7 (33.3%).
Conclusions:
The high incidence of uterine rupture is attributed to lack of prenatal care, labour in high-risk patients outside hospital because of declining economy, and more patients with two or more previously scarred uterus. The maternal and neonatal complications have remained very high in the developing countries. We recommend that all patients with a history of Caesarean delivery should be delivered in hospital and observed closely for progression of labour, recognition of an active phase arrest requires operative delivery.