Rupture of the gravid uterus

A detailed analysis of 129 cases of rupture of the gravid uterus between 1980 and 1983 is presented and compared with two previous reports from King Edward VIII Hospital, Durban, over the last 2 decades. Statistically significant decrease in the occurrence of this condition (from 2,7 to 1,06/1000 deliveries (P less than 0,001; chi 2 = 20,38)) and in the maternal mortality rate (from 12% to 3%) have taken place since the initial study. The most probable reasons for this improvement are the provision of a community-based obstetric service, the early detection of cephalopelvic disproportion, awareness of the condition, immediate and adequate resuscitation once the diagnosis is established, and the performance of a total abdominal hysterectomy as definitive treatment in most cases.