The increasing incidence and declining mortality of ruptured uterus in Enugu

A 10-year review of ruptured uterus at the University of Nigeria Teaching Hospital disclosed an incidence of 1 in 500 deliveries. The average incidence for booked patients alone was 1 in 1271 deliveries. The maternal and perinatal mortalities were 17% and 91% respectively, while the contributions of ruptured uterus to the overall hospital maternal and perinatal mortalities for the period under review were 4.1 and 2.6% respectively. In 1978, the average incidence of ruptured uterus in all patients delivered at the hospital increased from 1 in 787 in the 1st 5 years to 1 in 330 in the 2nd 5 years, while the maternal mortality from ruptured uterus decreased from 27% in the 1st 1/2 to 10% in the 2nd 1.2 of the study. The decline in maternal mortality in this environment is due to better availability of stored blood and management which included subtotal hysterectomy in many cases.